Anxiety and Plasma Cortisol at the Crest of the Circadian Cycle: Reappraisal of a Classical Hypothesis
Anxiety and Plasma Cortisol at the Crest of the Circadian Cycle: Reappraisal of a Classical Hypothesis
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昼夜节律周期顶峰的焦虑和血浆皮质醇：经典假设的重新评估
作者：
G. Curtis;R. Nesse;M. Buxton;D. Lippman
&NA;在恐惧症患者中，通过在接近肾上腺皮质功能昼夜节律周期的波峰时，启动和终止与各自避免的特定刺激的快速现场对抗（“体内洪水”），诱发和终止主观和行为标准的近最大焦虑。该程序与中度相关，但不显着，血浆皮质醇高于控制水平的一些，但不是所有的受试者。患者自评焦虑水平的差异并不能解释皮质醇反应的差异。这一发现将促使人们进一步重新评估情感唤醒是肾上腺皮质功能的关键心理决定因素这一假设。在洪水期间，主观行为唤醒和血浆皮质醇之间的分离可能是行为治疗师所说的“恐惧的绝望”的表现。
&NA; Near‐maximal anxiety by subjective and behavioral criteria was evoked and terminated in phobic patients by initiation and termination of rapid live confrontation (“flooding in vivo”) with the specific stimulus that each avoided, at a time approximating the crest of the circadian cycle of adrenal cortical function. The procedure was associated with moderate, but not marked, elevations of plasma cortisol above control levels in some, but not all, subjects. Differences in anxiety levels as self‐rated by the patients did not account for differences in cortisol response. The findings should stimulate further reevaluation of the hypothesis that affective arousal is the key psychological determinant of adrenal cortical function. Dissociation between subjective‐behavioral arousal and plasma cortisol during flooding may be a manifestation of what behavior therapists call “desynchrony of fear.”