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Bärtl C, Henze GI, Peter HL, Giglberger M, Bohmann P, Speicher N, Konzok J, Kreuzpointner L, Waller L, Walter H, Wüst S, Kudielka BM. Neural and cortisol responses to acute psychosocial stress in work-related burnout: The Regensburg Burnout Project. Psychoneuroendocrinology 2024; 161:106926. [PMID: 38118266 DOI: 10.1016/j.psyneuen.2023.106926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Revised: 11/22/2023] [Accepted: 12/10/2023] [Indexed: 12/22/2023]
Abstract
BACKGROUND While several attempts have been made to elucidate the pathophysiology of burnout, neural stress responses have not yet been investigated. Therefore, the aim of this study was to examine salivary cortisol and - for the first time - neural responses to acute psychosocial stress within a strictly specified sample consisting of individuals suffering from burnout (BO group) and a healthy comparison group (HC group). METHODS After a multi-stage recruitment procedure based on burnout symptomatology and pathogenesis, 55 individuals suffering from burnout (25 women) and 61 individuals serving as HC group (31 women) out of an initial sample of 1022 volunteers were exposed to acute psychosocial stress during functional magnetic resonance imaging (fMRI) applying ScanSTRESS. RESULTS No differences were found between the BO and the HC group with respect to cortisol and mean neural stress responses. However, an exploratory comparison of neural stress responses of the first and second run of ScanSTRESS (exposure-time effect) revealed group-specific response patterns in one cluster peaking in the left dorsal anterior cingulate cortex (dACC). While the neural activation of the HC group was higher in the first compared to the second run of ScanSTRESS (i.e., decreasing activation), this pattern was reversed in the BO group (i.e., increasing activation). CONCLUSIONS Our analysis mainly did not provide evidence for altered acute cortisol and mean neural stress responses in burnout. However, the BO group was characterized by a limited capacity to show decreasing activation over stress exposure-time and exhibited instead increasing activation. Importantly, this group difference manifested in the left dACC which is both involved in neural stress processing and affected in individuals suffering from burnout. Given the present results, it seems promising to further examining temporal dynamics of neural stress responses in (sub-) clinical conditions such as burnout.
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Affiliation(s)
- Christoph Bärtl
- Institute of Psychology, University of Regensburg, Regensburg, Germany.
| | - Gina-Isabelle Henze
- Institute of Psychology, University of Regensburg, Regensburg, Germany; Division of Mind and Brain Research, Department of Psychiatry and Psychotherapy, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Hannah L Peter
- Institute of Psychology, University of Regensburg, Regensburg, Germany
| | - Marina Giglberger
- Institute of Psychology, University of Regensburg, Regensburg, Germany
| | - Patricia Bohmann
- Institute of Psychology, University of Regensburg, Regensburg, Germany; Department of Epidemiology and Preventive Medicine, University of Regensburg, Regensburg, Germany
| | - Nina Speicher
- Institute of Psychology, University of Regensburg, Regensburg, Germany
| | - Julian Konzok
- Institute of Psychology, University of Regensburg, Regensburg, Germany; Department of Epidemiology and Preventive Medicine, University of Regensburg, Regensburg, Germany
| | | | - Lea Waller
- Division of Mind and Brain Research, Department of Psychiatry and Psychotherapy, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Henrik Walter
- Division of Mind and Brain Research, Department of Psychiatry and Psychotherapy, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Stefan Wüst
- Institute of Psychology, University of Regensburg, Regensburg, Germany
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Peter HL, Giglberger M, Streit F, Frank J, Kreuzpointner L, Rietschel M, Kudielka BM, Wüst S. Association of polygenic scores for depression and neuroticism with perceived stress in daily life during a long-lasting stress period. Genes Brain Behav 2023; 22:e12872. [PMID: 37876358 PMCID: PMC10733580 DOI: 10.1111/gbb.12872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 07/31/2023] [Accepted: 10/06/2023] [Indexed: 10/26/2023]
Abstract
Genetic factors contribute significantly to interindividual differences in the susceptibility to stress-related disorders. As stress can also be conceptualized as environmental exposure, controlled gene-environment interaction (GxE) studies with an in-depth phenotyping may help to unravel mechanisms underlying the interplay between genetic factors and stress. In a prospective-longitudinal quasi-experimental study, we investigated whether polygenic scores (PGS) for depression (DEP-PGS) and neuroticism (NEU-PGS), respectively, were associated with responses to chronic stress in daily life. We examined law students (n = 432) over 13 months. Participants in the stress group experienced a long-lasting stress phase, namely the preparation for the first state examination for law students. The control group consisted of law students without particular stress exposure. In the present manuscript, we analyzed perceived stress levels assessed at high frequency and in an ecologically valid manner by ambulatory assessments as well as depression symptoms and two parameters of the cortisol awakening response. The latter was only assessed in a subsample (n = 196). No associations between the DEP-PGS and stress-related variables were found. However, for the NEU-PGS we found a significant GxE effect. Only in individuals experiencing academic stress a higher PGS for neuroticism predicted stronger increases of perceived stress levels until the exam. At baseline, a higher NEU-PGS was associated with higher perceived stress levels in both groups. Despite the small sample size, we provide preliminary evidence that the genetic disposition for neuroticism is associated with stress level increases in daily life during a long-lasting stress period.
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Affiliation(s)
- Hannah L. Peter
- Institute of PsychologyUniversity of RegensburgRegensburgGermany
| | | | - Fabian Streit
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental HealthUniversity of MannheimMannheimGermany
| | - Josef Frank
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental HealthUniversity of MannheimMannheimGermany
| | | | - Marcella Rietschel
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental HealthUniversity of MannheimMannheimGermany
| | | | - Stefan Wüst
- Institute of PsychologyUniversity of RegensburgRegensburgGermany
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Giglberger M, Peter HL, Henze GI, Kraus E, Bärtl C, Konzok J, Kreuzpointner L, Kirsch P, Kudielka BM, Wüst S. Neural responses to acute stress predict chronic stress perception in daily life over 13 months. Sci Rep 2023; 13:19990. [PMID: 37968323 PMCID: PMC10651906 DOI: 10.1038/s41598-023-46631-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 11/03/2023] [Indexed: 11/17/2023] Open
Abstract
The importance of amygdala, hippocampus, and medial prefrontal cortex (mPFC) for the integration of neural, endocrine, and affective stress processing was shown in healthy participants and patients with stress-related disorders. The present manuscript which reports on one study-arm of the LawSTRESS project, aimed at investigating the predictive value of acute stress responses in these regions for biopsychological consequences of chronic stress in daily life. The LawSTRESS project examined law students either in preparation for their first state examination (stress group [SG]) or in the mid-phase of their study program (control group [CG]) over 13 months. Ambulatory assessments comprising perceived stress measurements and the cortisol awakening response (CAR) were administered on six sampling points (t1 = - 1 year, t2 = - 3 months, t3 = - 1 week, t4 = exam, t5 = + 1 week, t6 = + 1 month). In a subsample of 124 participants (SG: 61; CG: 63), ScanSTRESS was applied at baseline. In the SG but not in the CG, amygdala, hippocampus, and (post-hoc analyzed) right mPFC activation changes during ScanSTRESS were significantly associated with the trajectory of perceived stress but not with the CAR. Consistent with our finding in the total LawSTRESS sample, a significant increase in perceived stress and a blunted CAR over time could be detected in the SG only. Our findings suggest that more pronounced activation decreases of amygdala, hippocampus, and mPFC in response to acute psychosocial stress at baseline were related to a more pronounced increase of stress in daily life over the following year.
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Affiliation(s)
- Marina Giglberger
- Department of Psychology, University of Regensburg, Universitätsstraße 31, 93053, Regensburg, Germany
| | - Hannah L Peter
- Department of Psychology, University of Regensburg, Universitätsstraße 31, 93053, Regensburg, Germany
| | - Gina-Isabelle Henze
- Department of Psychology, University of Regensburg, Universitätsstraße 31, 93053, Regensburg, Germany
- Research Division of Mind and Brain, Department of Psychiatry and Psychotherapy CCM, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität Zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Elisabeth Kraus
- Department of Psychology, Computational Modeling in Psychology, Ludwig Maximilian University of Munich, Munich, Germany
| | - Christoph Bärtl
- Department of Psychology, University of Regensburg, Universitätsstraße 31, 93053, Regensburg, Germany
| | - Julian Konzok
- Department of Psychology, University of Regensburg, Universitätsstraße 31, 93053, Regensburg, Germany
- Department of Epidemiology and Preventive Medicine, University of Regensburg, Regensburg, Germany
| | - Ludwig Kreuzpointner
- Department of Psychology, University of Regensburg, Universitätsstraße 31, 93053, Regensburg, Germany
| | - Peter Kirsch
- Department of Clinical Psychology, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Heidelberg, Germany
| | - Brigitte M Kudielka
- Department of Psychology, University of Regensburg, Universitätsstraße 31, 93053, Regensburg, Germany
| | - Stefan Wüst
- Department of Psychology, University of Regensburg, Universitätsstraße 31, 93053, Regensburg, Germany.
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Giglberger M, Peter HL, Kraus E, Kreuzpointner L, Zänkert S, Henze GI, Bärtl C, Konzok J, Kirsch P, Rietschel M, Kudielka BM, Wüst S. Daily life stress and the cortisol awakening response over a 13-months stress period - Findings from the LawSTRESS project. Psychoneuroendocrinology 2022; 141:105771. [PMID: 35489313 DOI: 10.1016/j.psyneuen.2022.105771] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 03/15/2022] [Accepted: 04/15/2022] [Indexed: 12/18/2022]
Abstract
The LawSTRESS project is a controlled prospective-longitudinal study on psychological, endocrine, central nervous and genetic predictors of responses to long-lasting academic stress in a homogenous cohort. In this first project report, we focused on the association between daily life stress and the cortisol awakening response (CAR). The CAR, a distinct cortisol rise in the first 30-45 min after morning awakening, is a well-established marker of cortisol regulation in psychoneuroendocrinology. Law students from Bavarian universities (total n = 452) have been studied over a 13-months period at six sampling points starting 12 months prior exam. The stress group (SG) consisted of students experiencing a long-lasting and significant stress period, namely the preparation for the first state examination for law students. Law students assigned to the control group (CG) were studied over an equally long period without particular and sustained stress exposure. To investigate stress related alterations in the CAR, we examined a subsample of the LawSTRESS project consisting of 204 students with 97 participants from the SG (69.1% female, mean age = 22.84 ± 1.82) and 107 from the CG (78.5% female, mean age = 20.95 ± 1.93). At each sampling point, saliva samples for cortisol assessment were collected immediately upon awakening and 30 as well as 45 min later. Perceived stress in daily life was measured by repeated ambulatory assessments (about 100 queries over six sampling points). The time course of perceived stress levels in the two groups differed significantly, with the SG showing an increase in perceived stress until the exam and a decrease thereafter. Stress levels in the CG were relatively stable. The CAR was not significantly different between groups at baseline. However, a blunted CAR in the SG compared to the baseline measure and to the CG developed over the measurement timepoints and reached significance during the exam. Remarkably, this effect was neither associated with the increase in perceived stress nor with anxiety and depression symptoms, test anxiety and chronic stress at baseline. The present study successfully assessed multidimensional stress trajectories over 13 months and it documented the significant burden, law students preparing for the first state examination are exposed to. This period was related to a blunted CAR with presumed physiological consequences (e.g., on energy metabolism and immune function). Mean psychological stress levels as well as the CAR returned to baseline levels after the exam, suggesting a fast recovery in the majority of the participants.
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Affiliation(s)
- Marina Giglberger
- Department of Psychology, University of Regensburg, Regensburg, Germany
| | - Hannah L Peter
- Department of Psychology, University of Regensburg, Regensburg, Germany
| | - Elisabeth Kraus
- Department of Psychology, Educational Science and Sport Science, University of Regensburg, Regensburg, Germany
| | | | - Sandra Zänkert
- Department of Psychology, University of Regensburg, Regensburg, Germany
| | | | - Christoph Bärtl
- Department of Psychology, University of Regensburg, Regensburg, Germany
| | - Julian Konzok
- Department of Psychology, University of Regensburg, Regensburg, Germany
| | - Peter Kirsch
- Department of Clinical Psychology, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Heidelberg, Germany
| | - Marcella Rietschel
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, University of Heidelberg, Mannheim, Germany
| | | | - Stefan Wüst
- Department of Psychology, University of Regensburg, Regensburg, Germany.
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Peter HL, Hellhammer DH. Entzündungsbedingte Depression und assoziierte Risikofaktoren bei ambulanten Patienten. Verhaltenstherapie 2016. [DOI: 10.1159/000452785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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