音乐放松缓解作业人员应激情绪的研究

目的研究音乐放松对缓解特殊作业人员应激情绪的作用。方法在参加神舟十一号载人航天飞行任务的工作人员中招募志愿者15人,任务过程中和任务后各进行1次音乐放松。在音乐放松前、后采集主观体验指标和唾液皮质醇指标,音乐放松过程中采集心率变异性指标。结果音乐放松后,心率(heart rate,HR)降低[(71.08±7.97)beats/min vs.(68.15±7.05)beats/min)],相邻NN间期差的均方根(root mean square of successive differences,RMSSD)升高[(29.15±13.27)ms vs.(36.86±14.22ms)],高频功率(high frequency,HF)升高[(219.05±180.39)ms~2vs.(329.01±235.87)ms],差异均有统计学意义(P0.05)。唾液皮质醇(cortisol)水平降低[(6.50±1.04)ng/mL vs.(6.01±0.65)ng/mL],差异接近显著(P=0.079)。结论音乐放松对于缓解作业人员应激情绪具有积极作用,对于下丘脑-垂体-肾上腺(hypothalamo-pituitary-adrenal,HPA)轴和自主神经系统均有影响。     

Maternal depression and infant cortisol: influences of timing, comorbidity and treatment

Background: The current study examines the relationship between maternal depression and infant cortisol concentrations. The potential roles of comorbid maternal anxiety disorders, timing of maternal depression, and maternal treatment with psychotropic medications during pregnancy are addressed. Methods: Women with 6‐month‐old infants (105 boys and 84 girls) participated in a laboratory paradigm that included infant saliva collection at six points, noise burst and arm restraint stressor tasks, and a diagnostic interview of the mother. Results: Lifetime history of maternal depression was associated with increased baseline and mean (average) infant cortisol levels. Comorbidity with anxiety disorder was related to infant cortisol reactivity. Peripartum (prepartum and/or postpartum) maternal depression, rather than a pre‐pregnancy history of disorder, was associated with higher infant cortisol reactivity. Prenatal and postnatal exposure to maternal disorder had similar effects, but prenatal maternal psychotropic medication treatment appeared to attenuate infant cortisol increases associated with prenatal maternal disorder exposure. Conclusions: These data suggest that exposure to maternal depression and anxiety during pregnancy and the postpartum period may increase infant salivary cortisol. This maternal depression–infant cortisol association is independent of the effects of delivery complications, and appears to be modulated by prenatal maternal psychotropic treatment.     

Salivary Cortisol Release and Hypothalamic Pituitary Adrenal Axis Feedback Sensitivity in Fibromyalgia Is Associated With Depression But Not With Pain

Results on hypothalamicpituitary-adrenal (HPA) axis function in fibromyalgia are heterogeneous and studies that integrate psychological and biological mechanisms in the search for pathways to fibromyalgia are rare. The goal of the study was to evaluate cortisol release and HPA axis feedback regulation in fibromyalgia and its association with psychopathology and pain. Beneath assessment of pain thresholds and self-report of pain, salivary free cortisol release over the day before and after intake of 0.5 mg of dexamethasone was measured in 21 female patients with fibromyalgia and 26 control women. Depression was assessed by questionnaires and clinical interview. We found reduced feedback sensitivity and slightly enhanced cortisol release in patients with fibromyalgia compared with healthy control subjects. Post hoc analyses showed that these effects are exclusively found in those patients, who also had major depressive disorder. Patients with fibromyalgia had lower pain pressure threshold, whereas heat pain thresholds were comparable with control subjects. Pain pressure and heat pain thresholds were not associated with cortisol release. On the other hand measurements of affective pain experience and depression were positively correlated with salivary cortisol over the day. Our results support the hypotheses that HPA axis related alterations are associated with affective disturbances, for example, depression, in patients with fibromyalgia.     

Cortisol and externalizing behavior in children and adolescents: mixed meta-analytic evidence for the inverse relation of basal cortisol and cortisol reactivity with externalizing behavior

An inverse relation between cortisol (re)activity and externalizing behavior has been hypothesized, but research findings seem equivocal. We tested this hypo(re)activity hypothesis in two meta-analyses, one for basal cortisol (k = 72 studies, N = 5,480) and one for cortisol reactivity to a stressor (k = 29 studies, N = 2,601). No association was found between cortisol reactivity and externalizing behaviors (r = -.04, 95% CI = -.11, .02). However, the relation between basal cortisol and externalizing behavior was significant but small (r = -.05, 95% CI = -.10, -.002). The age of the children significantly moderated this relation: Externalizing behavior was associated with higher basal cortisol (hyperactivity) in preschoolers (r = .09, 95% CI = .002, .17), and with lower basal cortisol (hypoactivity) in elementary school-aged children (r = -.14, 95% CI = -.19, -.08). There was no significant relation between cortisol and externalizing behavior in adolescents.     

Return to school accompanied by changing associations between family ecology and cortisol

This study examines everyday family life as a social regulator of child adrenocortical activity during the normative challenge of return to school. If positive family function facilitates child adaptation, we expected that mother-child relationships following school entry would predict individual differences in evening cortisol, a context-sensitive marker for the response to concurrent demands. Among 28 children followed longitudinally, late in pre-kindergarten those living with single and/or employed mothers had higher evening cortisol. Yet early during the following school year, children with poorer mother-child relationships had higher evening cortisol. Cortisol awakening response, a comparatively stable marker of anticipated demands, was higher with maternal employment, single parents, and busier child schedules before school re-entry, and with maternal employment afterwards. We argue for a layered ecological approach to social regulation, recognizing that family structure, family functioning, and proximal features of everyday life within the family moderate child adrenocortical activity differently across contexts.     

Concurrent and longitudinal associations of basal and diurnal cortisol with mental health symptoms in early adolescence

Recent biosocial theories postulate that both biological risk and the social context influence the development of mental health problems [Boyce and Ellis (2005) Development and Psychopathology, 17(2), 271-301]. Guided by this framework, we examined whether basal cortisol and its diurnal rhythm were associated with mental health symptoms in early adolescence. Because cross-sectional and longitudinal investigations sometimes reveal different cortisol-mental health associations, we examined the association both concurrently and longitudinally when children transition to middle school, a time which entails a major change in social context from single to multiple teachers, classrooms, and sets of classmates. Salivary cortisol was measured three times a day (waking, afternoon, and bedtime) across 3 days when adolescents were 5th graders. Mental health was measured when adolescents were in 5th and 7th grades, just before and after the transition to middle school. To deal with the substantial comorbidity of internalizing and externalizing symptoms at this developmental stage, mental health measures distinguished overall symptom severity from the preponderance of internalizing versus externalizing symptoms (i.e., directionality). A three-level Hierarchical Linear Model was used to extract basal cortisol and its diurnal rhythm separate from the day-to-day and within-the-day fluctuations in cortisol in response to daily experiences. Results were specific to symptom severity, suggesting that cortisol is a nonspecific risk factor for mental health symptoms in young adolescents. At 5th grade, low basal cortisol was associated with concurrent symptom severity. However, longitudinally, it was adolescents with high cortisol at 5th grade who were at risk for increasing mental health symptoms by 7th grade. Flat diurnal rhythms in 5th grade were related to levels of symptom severity at both 5th and 7th grades. Considering the change in social context, as defined by the transition to middle school, helped resolve seemingly inconsistent evidence that both hypo- and hyper-arousal were associated with mental health symptoms in early adolescence.     

氯诺昔康围术期镇痛对患者血糖、胰岛素和皮质醇的影响

目的观察氯诺昔康围术期镇痛对机体血糖、胰岛素和血浆皮质醇水平的影响。方法24例在硬膜外麻醉下行择期胆囊切除术病人,随机分为氯诺昔康组(L组):经硬膜外腔单次推注吗啡1.5 mg和新斯的明1 mg并复合静脉推注氯诺昔康镇痛;对照组(C组):经硬膜外腔单次推注吗啡1.5 mg和新斯的明1 mg镇痛。于术前(T1)、术毕(T2)、术后第1天(T3)、术后第2天(T4)和术后第3天(T5)测定血糖、胰岛素和血浆皮质醇浓度,视觉模拟评分法(VAS)作术后4、24和48 h的静止与活动时VAS评分。结果C组术后4 h、术后24 h静止或活动VAS评分明显高于L组(P<0.05)。C组术毕、术后第1天、术后第2天血浆皮质醇浓度与术前比明显升高(P<0.05或0.01),而L组血浆皮质醇浓度仅术毕时显著增高(P<0.05);L组术毕、术后第1天、术后第2天血糖、血浆胰岛素和血浆皮质醇水平均显著低于C组(P<0.05或0.01)。结论氯诺昔康应用于围术期镇痛,增强硬膜外吗啡的镇痛效果,有效地遏制机体的高代谢状态,减轻术后糖代谢紊乱。     

Neuropsychological impairment in bipolar disorder: the relationship with glucocorticoid receptor function

OBJECTIVE: Basal levels of glucocorticoids, such as cortisol, are generally unaltered in bipolar disorder. However, neuroendocrine tests of glucocorticoid receptor (GR) function such as the dexamethasone suppression test (DST) are frequently abnormal. Neuropsychological impairment is well documented in healthy volunteers after administration of glucocorticoids and in patients with bipolar affective disorder. This suggests a potential link between neuropsychological and hypothalamic-pituitary-adrenal axis function. We examined the hypothesis that neuropsychological impairment in bipolar disorder is associated with abnormal GR function. METHODS: Seventeen euthymic bipolar patients and 16 controls completed tests of verbal declarative and working memory (WM) tests and the DST. The correlation between neuroendocrine and neuropsychological function was examined. RESULTS: Bipolar patients made significantly more errors of omission and commission on the WM paradigm and demonstrated impaired verbal recognition memory. Patients' post-dexamethasone cortisol correlated with WM commission errors (r(s) = 0.64, p = 0.0006). No such relationship was evident in controls. CONCLUSION: Deficits in declarative memory and WM are evident in patients with bipolar disorder. The deficit in retrieval accuracy from WM appears to be correlated with abnormal GR function.     

Social integration of daily activities and cortisol secretion: a laboratory based manipulation

A diverse body of literature suggests that social contacts have direct regulatory influences on biological rhythms such as the diurnal cortisol decline. Although our previous prospective research has found a link between social contacts and cortisol secretion, a manipulation of social contacts is necessary to definitively evaluate causality. The current study involved a laboratory-based manipulation of daily social contacts. Fifty-three females experienced both high and low social contact conditions in the lab while collecting ambulatory data on their social contact and cortisol levels. Data were analyzed using hierarchical linear modeling, such that cortisol production on high social contact days was compared within person to cortisol production on low social contact days. Although the manipulation successfully altered daily social contacts, it had no significant effect on cortisol slope. However, cortisol slope differences were significant when participants had contact with someone whom they usually saw every day. Social relationships that provide daily contact may have the strongest influence on biological rhythms.     

Homesickness,mood and self‐reported health

The present study focused on health status, mood, cognition, saliva cortisol, and social activities in homesick (N=80), homesick‐prone (N=152), recovered (N=48) and non‐homesick adult women (N=45). Self‐reported health and mood were decreased and cognitive functions were poorer in homesick and homesick‐prone subjects compared with non‐homesick and recovered persons. Cortisol levels, on the other hand, failed to differ among the four groups. Furthermore, homesick, homesick‐prone and recovered individuals reported more difficulties making friends, fear of heights, dislike of travelling alone, school phobia and less club membership in childhood compared to the non‐homesick. It is suggested that a personality‐linked vulnerability factor is responsible for making anxious individuals prone to develop homesickness. Copyright © 1999 John Wiley & Sons, Ltd.