Cortisol response to social stress in parentally bereaved youth.
Cortisol response to social stress in parentally bereaved youth.
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DOI：
10.1016/j.biopsych.2012.08.016
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发表时间：
2013-02-15
影响因子：
10.6
通讯作者：
Brent, David A.
中科院分区：
文献类型：
--
作者：
Dietz, Laura J.;Stoyak, Samuel;Melhem, Nadine;Porta, Giovanna;Matthews, Karen A.;Payne, Monica Walker;Brent, David A.
丧亲之痛与青少年精神疾病和功能障碍的风险增加有关。下丘脑-垂体-肾上腺（HPA）轴功能失调可能是失去亲人的儿童经历不良后果风险增加的一种途径。然而，很少有研究前瞻性地研究父母丧亲之痛与皮质醇反应之间的关系，同时考虑到青少年及其照顾者的精神疾病。在父母去世后 5 年期间的多个时间点对 181 名失去亲人的和未失去亲人的后代及其照顾者进行了评估。后代参与了特里尔社会压力任务（TSST）的改编，并在暴露于社会压力源之前和之后收集了唾液皮质醇样本。使用重复测量的混合模型来分析丧亲状态、后代和照顾者的精神疾病以及人口统计指数对皮质醇反应轨迹的影响。在控制人口变量和后代抑郁症后，与未失去亲人的后代相比，失去亲人的后代表现出显着不同的皮质醇反应轨迹，其特点是总皮质醇输出较高，并且缺乏对急性社会压力的皮质醇反应。在失去亲人的群体中，父母因自然死亡而死亡的后代表现出对社会压力的显着皮质醇反应，而父母自杀身亡的后代则表现出更迟钝的皮质醇反应轨迹。失去父母的年轻人比没有失去父母的年轻人表现出更高的皮质醇输出，但面对社会压力时的敏锐反应能力较差。
Parental bereavement is associated with increased risk for psychiatric illness and functional impairment in youth. Dysregulated hypothalamic-pituitary-adrenal (HPA) axis functioning may be one pathway through which bereaved children experience increased risk for poor outcomes. However, few studies have prospectively examined the association between parental bereavement and cortisol response while accounting for psychiatric disorders in both youth and their caregivers. One-hundred and eighty-one bereaved and nonbereaved offspring and their caregivers were assessed at multiple time points over a 5-year period after parental death. Offspring participated in an adaptation of the Trier Social Stress Task (TSST), and salivary cortisol samples were collected before and after exposure to social stressors. Mixed models for repeated measures were used to analyze the effects of bereavement status, psychiatric disorder in both offspring and caregiver, and demographic indices on trajectories of cortisol response. After controlling for demographic variables and offspring depression, bereaved offspring demonstrated significantly different trajectories of cortisol response compared with nonbereaved offspring, characterized by higher total cortisol output and an absence of cortisol reactivity to acute social stress. Within the bereaved group, offspring of parents who died by sudden natural death demonstrated significant cortisol reactivity to social stress compared with offspring whose parents died by suicide, who demonstrated more blunted trajectory of cortisol response. Parentally bereaved youth demonstrate higher cortisol output than nonbereaved youth but are less able to mount an acute response in the face of social stressors.
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DOI：
10.1176/appi.ajp.2009.08081244
发表时间：
2009-07
期刊：
The American journal of psychiatry
影响因子：
--
作者：
Brent D;Melhem N;Donohoe MB;Walker M
通讯作者：
Walker M
影响因子：
6.9
作者：
Kendler, KS;Sheth, K;Prescott, CA
通讯作者：
Prescott, CA
影响因子：
6.6
作者：
BIFULCO, AT;BROWN, GW;HARRIS, TO
通讯作者：
HARRIS, TO
影响因子：
10.6
作者：
Carrion, VG;Weems, CF;Reiss, AL
通讯作者：
Reiss, AL
影响因子：
6.9
作者：
HARRIS, T;BROWN, GW;BIFULCO, A
通讯作者：
BIFULCO, A