Effects of mood and rumination on cortisol levels in daily life: An ambulatory assessment study in remitted depressed patients and healthy controls
Effects of mood and rumination on cortisol levels in daily life: An ambulatory assessment study in remitted depressed patients and healthy controls
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DOI：
10.1016/j.psyneuen.2013.04.014
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发表时间：
2013-10-01
影响因子：
3.7
通讯作者：
Kuehner, Christine
中科院分区：
文献类型：
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作者：
Huffziger, Silke;Ebner-Priemer, Ulrich;Kuehner, Christine
自然发生的情绪和认知经验对下丘脑-垂体-肾上腺轴（HPAA）活动的影响仍然研究不足，特别是在临床人群中。本研究探讨情绪和反刍皮质醇水平在日常生活中的缓解抑郁症患者复发发作或慢性前驱（n = 31）和健康对照组（n = 32）的影响。对主观变量（效价、平静度、能量唤醒、反刍自我关注）、日常应激源和唾液皮质醇样本进行连续两个工作日每天五次的动态评估，其中皮质醇在主观评估后20分钟收集。此外，抑郁症状和特质反刍（沉思，反射）进行了回顾性测量。多水平模型显示，与健康对照组相比，缓解的抑郁症患者表现出较低的皮质醇活性。抑郁症状和特质反刍没有预测HPAA活动，而通过控制日常的压力，较高的每日平均值的反刍自我关注和较低的每日平均价，精力充沛的觉醒和冷静与较高的每日皮质醇水平。每组的单独分析显示，平均每日反刍自我关注预测在两个样本中较高的皮质醇。相比之下，较低的日常平静手段，但也价和精力充沛的觉醒，显着相关的皮质醇输出较高，只有在健康对照组，但不是在病人样本。这些发现表明，自然发生的反刍和情绪低落与日常生活中HPAA的激活增加有关。此外，我们的数据显示，缓解复发性抑郁症的情绪皮质醇耦合可能会减少，这可能表明，在复发性抑郁症的过程中，HPAA激活可能会变得对自然环境中微妙的情感体验反应不那么敏感。(C)2013爱思唯尔有限公司保留所有权利。
The influence of naturally occurring emotional and cognitive experiences on hypothalamic pituitary adrenal axis (HPAA) activity is still underinvestigated, particularly in clinical populations. The present study examined effects of mood and rumination on cortisol levels in daily life in remitted depressed patients with recurrent episodes or a chronic precourse (n = 31) and healthy controls (n = 32). Ambulatory assessment of subjective variables (valence, calmness, energetic-arousal, ruminative self-focus), daily stressors, and saliva cortisol samples was performed five times a day on two consecutive workdays, whereby cortisol was collected 20 min after the subjective assessments. In addition, depressive symptoms and trait rumination (brooding, reflection) were measured retrospectively. Multilevel models revealed that remitted depressed patients showed lower cortisol activity compared to healthy controls. Depressive symptoms and trait rumination did not predict HPAA activity, whereas, by controlling for daily stressors, higher daily means of ruminative self-focus and lower daily means of valence, energetic arousal and calmness were associated with higher daily cortisol levels. Separate analyses per group revealed that mean daily ruminative self-focus predicted higher cortisol in both samples. In contrast, lower daily means of calmness, but also of valence and energetic arousal, were significantly linked to higher cortisol output only in healthy controls, but not in the patient sample. These findings indicate that naturally occurring rumination and low mood are associated with increased activation of the HPAA in daily life. Moreover, our data revealed a potentially reduced mood cortisol coupling in remitted recurrent depression, possibly indicating that during the course of recurrent depression HPAA activation might become less responsive toward subtle emotional experiences in natural contexts. (C) 2013 Elsevier Ltd. All rights reserved.