Prospective associations between the cortisol awakening response and first onsets of anxiety disorders over a six-year follow-up-2013 Curt Richter Award Winner
Prospective associations between the cortisol awakening response and first onsets of anxiety disorders over a six-year follow-up-2013 Curt Richter Award Winner
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DOI：
10.1016/j.psyneuen.2014.02.014
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发表时间：
2014-06-01
影响因子：
3.7
通讯作者：
Craske, Michelle G.
中科院分区：
文献类型：
--
作者：
Adam, Emma K.;Vrshek-Schallhorn, Suzanne;Craske, Michelle G.
已经发现焦虑障碍(ADS)和下丘脑-垂体-肾上腺(HPA)轴功能之间的横断面关联，通过唾液皮质醇水平来衡量，但缺乏前瞻性数据，就像检查特定ADS的研究一样。我们之前已经证明，皮质醇昼夜节律的一个方面，皮质醇唤醒反应(CAR)，可以前瞻性地预测严重抑郁障碍(MDD)的新发病和复发。在这里，我们试图检查它是否也预测广告。参与者(N=232)来自规模更大的西北-加州大学洛杉矶分校青年情感项目，这是一项针对年龄较大的青少年的两点纵向研究，旨在确定情绪和焦虑障碍的共同和特定风险因素。在心理健康诊断的基线访谈后，一组青少年完成了为期三天的皮质醇采样方案，测量汽车和其他昼夜节律指数。皮质醇测量时既往或现在有焦虑症的参与者被排除在外，并使用Cox回归(生存分析)来预测随后六年的首次ADS。对其中最大的子集是社交焦虑症(SAD)的首发症状(N=11)的25个AD首发症状进行了6次年度随访诊断访谈。即使在对过去和未来的MDD首发和其他协变量进行统计调整后，较高的汽车也会显著预测广告首发的增加(HR=2.20，p
Cross-sectional associations have been found between anxiety disorders (ADs) and hypothalamic-pituitary-adrenal (HPA) axis functioning, as measured by levels of salivary cortisol, but prospective data are lacking, as are studies examining specific ADs. We have previously shown that one aspect of the diurnal rhythm of cortisol, the cortisol awakening response (CAR), prospectively predicts both new onsets and recurrences of major depressive disorder (MDD). Here we sought to examine whether it also predicts ADs. Participants (N = 232) were drawn from the larger Northwestern-UCLA Youth Emotion Project, a two-site, longitudinal study of older adolescents, which aims to identify common and specific risk factors for mood and anxiety disorders. After baseline interviews for mental health diagnoses, a subset of adolescents completed a three-day cortisol sampling protocol measuring the CAR and other diurnal rhythm indices. Participants with past or current anxiety disorders at the time of cortisol measurement were excluded and Cox regression (survival analysis) was used to predict first onsets of ADs over the subsequent six years. AD onsets (N = 25), the largest subset of which were social anxiety disorder (SAD) onsets (N = 11), were observed over six annual follow up diagnostic interviews. Even when statistically adjusting for past and prospective MDD onsets and other covariates, a higher CAR significantly predicted increased first onsets of ADs (HR = 2.20, p