A Simple Stress Test For The Evaluation of Hypothalamic-Pituitary-Adrenal Axis during the First 6 Months of Life

This study examined whether perceived attachment security (i.e., perceptions of caregivers as responsive, available, and open to communication during times of need) and effortful coping work in concert to buffer against uncontrollable life event effects on hypothalamic–pituitary–adrenal axis (HPA) response patterns in preadolescent boys and girls ( N = 121, mean age = 10.60 years). Children completed the Trier Social Stress Test (TSST) and were immediately thereafter exposed to one of two randomly assigned coping conditions: distraction and avoidance. Piecewise growth multilevel modeling of children’s salivary cortisol levels over the course of the experimental protocol suggested that uncontrollable life events in the year prior were associated with exaggerated cortisol reactivity, though this pattern was buffered against by children’s secure attachment beliefs. Furthermore, perceived attachment security, uncontrollable life event, and coping condition interactive effects on cortisol recovery emerged. As expected, distraction supported efficient cortisol recovery for those uncontrollable stress-exposed children with secure beliefs, and avoidance worked in this fashion for those with insecure beliefs. Findings point to perceived attachment security as a putative buffer of stress-exposed preadolescents’ HPA reactivity and possible contributor to regulatory fit, informing how specific coping skills work or backfire in supporting these children’s HPA recovery efficiency.

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Predicting mental disorders from hypothalamic-pituitary-adrenal axis functioning: a 3-year follow-up in the TRAILS study

Psychological Medicine ◽

10.1017/s0033291715000392 ◽

2015 ◽

Vol 45 (11) ◽

pp. 2403-2412 ◽

Cited By ~ 12

Author(s):

E. Nederhof ◽

F. V. A. van Oort ◽

E. M. C. Bouma ◽

O. M. Laceulle ◽

A. J. Oldehinkel ◽

...

Keyword(s):

Mental Disorders ◽

Social Stress ◽

Stress Test ◽

Hypothalamic Pituitary Adrenal Axis ◽

Experimental Session ◽

Hypothalamic Pituitary Adrenal ◽

Adrenal Axis ◽

Delayed Recovery ◽

Pituitary Adrenal Axis

BackgroundHypothalamic-pituitary-adrenal axis functioning, with cortisol as its major output hormone, has been presumed to play a key role in the development of psychopathology. Predicting affective disorders from diurnal cortisol levels has been inconclusive, whereas the predictive value of stress-induced cortisol concentrations has not been studied before. The aim of this study was to predict mental disorders over a 3-year follow-up from awakening and stress-induced cortisol concentrations.MethodData were used from 561 TRAILS (TRacking Adolescents’ Individual Lives Survey) participants, a prospective cohort study of Dutch adolescents. Saliva samples were collected at awakening and half an hour later and during a social stress test at age 16. Mental disorders were assessed 3 years later with the Composite International Diagnostic Interview (CIDI).ResultsA lower cortisol awakening response (CAR) marginally significantly predicted new disorders [odds ratio (OR) 0.77, p = 0.06]. A flat recovery slope predicted disorders with a first onset after the experimental session (OR 1.27, p = 0.04). Recovery revealed smaller, non-significant ORs when predicting new onset affective or anxiety disorders, major depressive disorder, or dependence disorders in three separate models, corrected for all other new onsets.ConclusionsOur results suggest that delayed recovery and possibly reduced CAR are indicators of a more general risk status and may be part of a common pathway to psychopathology. Delayed recovery suggests that individuals at risk for mental disorders perceived the social stress test as less controllable and less predictable.

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Hypothalamic-pituitary-adrenal axis stress test in patients with early RA: role of corticotropin-releasing hormone promoter polymorphisms

Annals of the Rheumatic Diseases ◽

10.1136/ard.2011.151340 ◽

2011 ◽

Vol 70 (11) ◽

pp. 2058-2059 ◽

Cited By ~ 2

Author(s):

O. Malysheva ◽

U. Wagner ◽

M. Wahle ◽

M. Pierer ◽

U. Wagner ◽

...

Keyword(s):

Stress Test ◽

Hypothalamic Pituitary Adrenal Axis ◽

Corticotropin Releasing Hormone ◽

Promoter Polymorphisms ◽

Hypothalamic Pituitary Adrenal ◽

Releasing Hormone ◽

Adrenal Axis ◽

Early Ra ◽

Pituitary Adrenal Axis

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Differential Hypothalamic-Pituitary-Adrenal Axis Reactivity to Psychological and Physical Stress1

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/jcem.84.6.5746 ◽

1999 ◽

Vol 84 (6) ◽

pp. 1944-1948 ◽

Cited By ~ 2

Author(s):

Anita Singh ◽

John S. Petrides ◽

Philip W. Gold ◽

George P. Chrousos ◽

Patricia A. Deuster

Keyword(s):

Psychological Stress ◽

Trait Anxiety ◽

Mental Arithmetic ◽

Stress Test ◽

Hypothalamic Pituitary Adrenal Axis ◽

Exercise Stress ◽

Hypothalamic Pituitary Adrenal ◽

Fitness Level ◽

Adrenal Axis ◽

Pituitary Adrenal Axis

Healthy men exhibit a differential hypothalamic-pituitary-adrenal axis (HPA) response to exercise stress and fall into two groups: high responders (HR) and low responders (LR). The present study examined whether HR to physical stress also exhibit higher HPA reactivity to psychological stress than LR. We examined 14 HR and 13 LR classified based on their ACTH responses to high intensity exercise after pretreatment with dexamethasone. Both groups were of similar age, height, weight, and fitness level. Trait anxiety scores on the Spielberger Trait Anxiety Scale were not different. Subjects underwent a psychological stress test consisting of an interview and mental arithmetic. This test raised heart rate, blood pressure, and plasma ACTH and cortisol levels in both HR and LR. HR tended to have higher heart rates and blood pressures in anticipation of the psychological stress test than LR. ACTH responses of HR were higher, although not significantly, throughout the psychological stress test than LR. HR had a significantly (P < 0.05) greater net integrated cortisol response to the psychological stress than LR. This suggests that the adrenal cortexes of the HR are hypertropic and/or hypersensitive to ACTH. We conclude that men who are highly responsive to exercise stress are also highly responsive to psychological stress.

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Attenuated hypothalamic–pituitary–adrenal axis functioning predicts accelerated pubertal development in girls 1 year later

Development and Psychopathology ◽

10.1017/s0954579414000790 ◽

2014 ◽

Vol 27 (3) ◽

pp. 819-828 ◽

Cited By ~ 17

Author(s):

Darby E. Saxbe ◽

Sonya Negriff ◽

Elizabeth J. Susman ◽

Penelope K. Trickett

Keyword(s):

Social Stress ◽

Stress Test ◽

Pubertal Development ◽

Area Under The Curve ◽

Gonadal Development ◽

Hypothalamic Pituitary Adrenal Axis ◽

Trier Social Stress Test ◽

Hypothalamic Pituitary Adrenal ◽

Adrenal Axis ◽

Pituitary Adrenal Axis

AbstractAccelerated pubertal development has been linked to adverse early environments and may heighten subsequent mental and physical health risks. Hypothalamic–pituitary–adrenal axis functioning has been posited as a mechanism whereby stress may affect pubertal development, but the literature lacks prospective tests of this mechanism. The current study assessed 277 youth (M = 10.84 years, SD = 1.14), 138 boys and 139 girls, who reported on their pubertal development and underwent the Trier Social Stress Test for Children at baseline and returned to the laboratory approximately 1 year later (M = 1.12 years, range = 0.59–1.98 years). For girls, lower cortisol area under the curve (with respect to ground) at Time 1 predicted more advanced pubertal development at Time 2, controlling for Time 1 pubertal development. This association persisted after additional covariates including age, body mass index, race, and maltreatment history were introduced, and was driven by adrenal rather than gonadal development. Cortisol was not linked to boys' subsequent pubertal development, and no interaction by gender or by maltreatment appeared. These results suggest that attenuated cortisol, reported in other studies of children exposed to early adversity, may contribute to accelerated pubertal tempo in girls.

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Effects of Suckling on Hypothalamic-Pituitary-Adrenal Axis Responses to Psychosocial Stress in Postpartum Lactating Women

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/jcem.86.10.7919 ◽

2001 ◽

Vol 86 (10) ◽

pp. 4798-4804 ◽

Cited By ~ 176

Author(s):

Markus Heinrichs ◽

Gunther Meinlschmidt ◽

Inga Neumann ◽

Sabine Wagner ◽

Clemens Kirschbaum ◽

...

Keyword(s):

Breast Feeding ◽

Stress Test ◽

Hypothalamic Pituitary Adrenal Axis ◽

Psychosocial Stressor ◽

Short Term ◽

Lactating Women ◽

Hypothalamic Pituitary Adrenal ◽

Adrenal Axis ◽

Free Cortisol ◽

Pituitary Adrenal Axis

In several studies lactation has been shown to be associated with a hypothalamic-pituitary-adrenal axis hyporesponsiveness to physical and psychological stressors. As it is not known whether the marked blunting of endocrine stress reactivity in women can be ascribed to suckling as a short-term effect or to lactation in general, the acute effects of suckling on the hypothalamic-pituitary-adrenal axis and the sympathetic-adrenal-medullary system responses to mental stress were investigated in lactating women. Forty-three lactating women were randomly assigned either to breast-feed or to hold their infants for a 15-min period with the onset 30 min before they were exposed to a brief psychosocial stressor (Trier Social Stress Test). Both breast-feeding and holding the infant yielded significant decreases in ACTH, total plasma cortisol, and salivary free cortisol (all P < 0.01). There were no significant differences in baseline hormone levels between the groups 1 min before the stress test. In response to stress exposure, ACTH, total plasma cortisol, salivary free cortisol, norepinephrine, and epinephrine were significantly increased in all lactating women (all P < 0.001). However, total cortisol and free cortisol responses to stress were attenuated in breast-feeding women (P = 0.001 and P = 0.067, respectively), who also showed significantly decreasing PRL levels during the stress test (P = 0.005). In addition, there was no change in plasma oxytocin or vasopressin in response to the stressor. Breast-feeding as well as holding led to decreased anxiety (P < 0.05), whereas, in contrast, stress exposure worsened mood, calmness, and anxiety in the total group (all P < 0.001). From these data we conclude that lactation in women, in contrast to that in rats, does not result in a general restraint of the hypothalamic-pituitary-adrenal axis response to a psychosocial stressor. Rather, suckling is suggested to exert a short-term suppression of the cortisol response to mental stress.

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