Alterations in HPA-axis and autonomic nervous system functioning in childhood anxiety disorders point to a chronic stress hypothesis
Alterations in HPA-axis and autonomic nervous system functioning in childhood anxiety disorders point to a chronic stress hypothesis
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DOI：
10.1016/j.psyneuen.2014.09.002
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发表时间：
2015-01-01
影响因子：
3.7
通讯作者：
Verhulst, Frank C.
中科院分区：
文献类型：
--
作者：
Dieleman, Gwendolyn C.;Huizink, Anja C.;Verhulst, Frank C.
背景：儿童期焦虑障碍（AD）是否可以用一个分类学结构来描述仍有争议。本研究探讨了知觉觉醒（PA），自主神经系统（ANS）和下丘脑-垂体-肾上腺（HPA）轴的措施是否可以区分儿童与不同的初步诊断的临床焦虑症（AD）彼此，并从一般人群参考组（GP）。研究样本包括152名AD儿童（比较分离焦虑症、广泛性焦虑症、社交恐惧症和特定恐惧症），年龄8- 12岁，和200名同龄的参考儿童。HPA轴功能测定的昼夜皮质醇配置文件。ANS功能通过连续测量休息时和心算任务期间的皮肤电导水平以及休息时的高频心率变异性来测量。PA进行了评估，通过一个questionnaire.Results：AD样本显示较低的高频心率变异性在休息期间，提高预期PA，较高的基础和反应性皮肤电导水平和较低的基础HPA轴功能相比，GP样本。存在三种或三种以上的临床疾病，即高临床“负荷”，与基础HPA轴功能较低，皮肤电导水平较高，测试后PA较低。在较高的皮肤电导水平上，特异性恐惧症可以与社交恐惧症和分离焦虑症区分开来。结论：AD儿童具有特异性的心理生理特征，与慢性应激的心理生理特征相似。高临床“负荷”与ANS和HPA轴功能改变相关。总体而言，ANS和HPA轴功能与AD总体相关，接受特定恐惧症。(C)2014爱思唯尔有限公司版权所有。
Background: It is of debate whether or not childhood anxiety disorders (AD) can be captured by one taxonomic construct. This study examined whether perceived arousal (PA), autonomic nervous system (ANS) and hypothalamic-pituitary-adrenal (HPA) axis measures can distinguish children with different primary diagnoses of clinical anxiety disorders (AD) from each other, and from a general population reference group (GP).Methods: The study sample consisted of 152 AD children (comparing separation anxiety disorder, generalized anxiety disorder, social phobia and specific phobia), aged 8- to 12-years, and 200 same-aged reference children. HPA-axis functioning was measured by a diurnal cortisol profile. ANS functioning was measured by continuous measures of skin conductance level in rest and during a mental arithmetic task and high frequency heart rate variability in rest. PA was assessed by a questionnaire.Results: The AD sample showed lower high frequency heart rate variability during rest, heightened anticipatory PA, higher basal and reactive skin conductance levels and lower basal HPA-axis functioning compared to the GP sample. The existence of three or more clinical disorders, i.e. a high clinical 'load', was associated with lower basal HPA-axis functioning, higher skin conductance level and lower posttest PA. Specific phobia could be discerned from social phobia and separation anxiety disorder on higher skin conductance level.Conclusions: Our findings indicated that children with AD have specific psychophysiological characteristics, which resemble the psychophysiological characteristics of chronic stress. A high clinical 'load' is associated with an altered ANS and HPA-axis functioning. Overall, ANS and HPA-axis functioning relate to AD in general, accept for specific phobia. (C) 2014 Elsevier Ltd. All rights reserved.