Hypothalamus-Pituitary-Adrenal Axis Hyperresponsiveness Is Associated with Increased Social Avoidance Behavior in Social Phobia
Hypothalamus-Pituitary-Adrenal Axis Hyperresponsiveness Is Associated with Increased Social Avoidance Behavior in Social Phobia
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DOI：
10.1016/j.biopsych.2008.08.022
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发表时间：
2009-02-15
影响因子：
10.6
通讯作者：
Elzinga, Bernet M.
中科院分区：
文献类型：
--
作者：
Roelofs, Karin;van Peer, Jacobien;Elzinga, Bernet M.
背景：动物的社交回避和抑制与糖皮质激素应激系统的高反应性有关。在人类中，糖皮质激素应激反应与社会回避行为之间的关系在很大程度上仍未被探索。我们研究了社交焦虑障碍（SAD）患者皮质醇应激反应的增加是否与社交回避行为的增加有关。方法：对18例SAD患者、22例健康对照组和17例创伤后应激障碍（PTSD）患者分别进行基线条件和特里尔社会压力测试提供的社会压力条件下的社会接近-回避任务（AA-task）测试。aa任务是一项计算机化的反应时间任务，测量人工接近和回避对视觉呈现的社会威胁线索（愤怒的脸）的反应速度。在整个实验过程中，对唾液皮质醇、血压和主观焦虑进行了评估。结果：与健康和PTSD对照组相比，SAD患者在社会压力测试中表现出更大的皮质醇反应。最重要的是，这些增加的皮质醇反应与社交逃避行为的增加显著相关，这是通过在社交压力条件下的aa任务来测量的。另一项回归分析表明，皮质醇反应预测了压力引起的社交回避倾向的增加，超过了血压和主观焦虑的影响。结论：这些发现为SAD患者皮质醇应激反应增加与社交回避行为之间的直接联系提供了第一个证据。这些结果支持了社会回避和抑制的动物模型，并可能具有重要的治疗意义。
Background: Social avoidance and inhibition in animals is associated with hyperresponsiveness of the glucocorticoid stress-system. In humans, the relation between glucocorticoid stress-reactivity and social avoidance behavior remains largely unexplored. We investigated whether increased cortisol stress-responsiveness is linked to increased social avoidance behavior in patients with social anxiety disorder (SAD).Methods: Patients with SAD (n = 18) as well as two control groups of healthy participants (n = 22) and patients with posttraumatic stress disorder (PTSD; n = 17), respectively, performed a social approach-avoidance task (AA-task) in a baseline condition and in a social stress OF condition (provided by the Trier Social Stress Test). The AA-task is a computerized reaction-time task measuring the speed of manual approach and avoidance responses to visually presented social threat cues (angry faces). Salivary cortisol, blood pressure, and subjective anxiety were assessed throughout the experiment.Results: Patients with SAD showed larger cortisol responses to the social stress test, as compared with healthy and PTSD control subjects. Most crucially, these increased cortisol responses were significantly correlated to the increase in social avoidance behavior measured by the AA-task in the social stress condition in SAD. An additional regression analysis showed that the cortisol responses predicted the stress-induced increase in social avoidance tendencies over and above the effects of blood pressure and subjective anxiety.Conclusions: These findings provide the first evidence for a direct link between increased cortisol stress-responsiveness and social avoidance behavior in patients with SAD. The results support animal models of social avoidance and inhibition and might have important treatment implications.