The psychology of HPA axis activation: Examining subjective emotional distress and control in a phobic fear exposure model.
The psychology of HPA axis activation: Examining subjective emotional distress and control in a phobic fear exposure model.
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DOI：
10.1016/j.psyneuen.2017.02.001
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发表时间：
2017-08
影响因子：
3.7
通讯作者：
Abelson JL
中科院分区：
文献类型：
--
作者：
Mayer SE;Snodgrass M;Liberzon I;Briggs H;Curtis GC;Abelson JL
HPA 轴在调节“压力”对健康的影响方面发挥着关键作用，但澄清机制需要了解心理生物联系。长期以来有一个隐含的假设，即主观情绪困扰（例如恐惧）应该激活 HPA 轴。尽管这一假设在 25 年前就受到了挑战，但针对人类的实验室研究仍然有限。在这项研究中，我们试图复制 Curtis 的研究结果，并通过研究压力源控制的存在或不存在是否影响恐惧暴露模型中的 HPA 轴反应性来扩展它。我们招募了 19-45 岁的特定恐惧症参与者（n = 32 名蜘蛛/蛇恐惧症患者；n = 14 名幽闭恐惧症患者），并逐渐让他们接触自己害怕的物体或情况，同时测量荷尔蒙（促肾上腺皮质激素和皮质醇）和主观（情绪困扰、感知控制）反应。利用二元轭设计，我们将参与者控制暴露速度时的 HPA 反应性与在缺乏控制的情况下给予匹配参与者的相同暴露量进行比较。结果表明，恐惧暴露会产生强烈的情绪困扰，但 HPA 轴活动却没有相应增加。尽管我们对控制的实际操纵未能影响 HPA 反应，但暴露期间的感知控制与较低的皮质醇有关，这种影响受到压力源控制的实际可用性的调节。我们的研究结果复制了柯蒂斯的研究结果，并挑战了仍然常见但不受支持的假设，即 HPA 轴活动反映了主观痛苦。这些结果还强调了压力源控制的感知和实际方面对于理解 HPA 轴系统真正“压力”的重要性。
The HPA axis plays a key role in mediating the effects of “stress” on health, but clarifying mechanisms requires an understanding of psycho-biological linkages. There has long been an implicit assumption that subjective emotional distress (e.g., fear) should activate the HPA axis. Although this assumption was challenged 25 years ago, laboratory studies in humans are limited. In this study we sought to replicate Curtis` findings and extend it by investigating if presence or absence of stressor control shapes HPA axis reactivity in a phobic fear exposure model. We recruited 19–45-year-old specific phobia participants (n = 32 spider/snake phobia; n = 14 claustrophobia) and gradually exposed them to their feared object or situation while measuring hormonal (ACTH and cortisol) and subjective (emotional distress, perceived control) responses. Utilizing a dyadic yoked design, we compared HPA reactivity when the pace of exposure was controlled by participants to identical exposure given to matched participants in the absence of control. Results showed that phobic fear exposure generated intense emotional distress without a corresponding increase in HPA axis activity. Although our actual manipulation of control failed to impact HPA responses, perceived control during exposure was associated with lower cortisol, an effect that was moderated by actual availability of stressor control. Our findings replicate Curtis` findings and challenge the still common but unsupported assumption that HPA axis activity reflects subjective distress. These results also highlight the importance of both perceived and actual aspects of stressor control in understanding what is truly “stressful” to the HPA axis system.