Early life stress and psychiatric disorder modulate cortical responses to affective stimuli

Altered affective processing has been proposed as mediating between early life stress (ELS) and subsequent psychopathology. The present study examined whether ELS influences affective cortical processing differently in psychiatric patients and healthy subjects. The number of stressful experiences before onset of puberty was assessed in 50 inpatients with diagnoses of Major Depressive Disorder, schizophrenia, drug addiction, or Borderline Personality Disorder and in 20 healthy comparison subjects. Subjects monitored pleasant, neutral, and unpleasant pictures during magnetoencephalographic recording. Suppression of right-posterior activity 160–210 ms after stimulus onset was associated with certain diagnoses and high ELS. Results confirmed specific contributions of ELS versus adult stress, comorbid posttraumatic stress disorder, or depression.     

Use of ecological momentary assessment in mood disorders research

Ecological momentary assessment (EMA) entails repeated, intensive sampling of respondents' current experiences while they are engaged in their typical daily routines, in their natural environments. In this article we discuss benefits of using EMA techniques in mood disorders research, provide an overview of the various specific EMA techniques that have been used with mood-disordered populations to date, and summarize the diverse range of research questions that EMA has been used to explore in this field. In addition, we evaluate the feasibility and acceptability of using EMA techniques with this population and suggest additional areas that might be fruitful to investigate, with a focus on the extension of EMA techniques into treatment research. Overall, data suggest that using EMA techniques in mood disorders research is feasible, generally acceptable, and highly promising. We conclude with a discussion of caveats, limitations, and ethical considerations.     

Solitude and cortisol: associations with state and trait affect in daily life

The social context can impact psychological and physiological functioning. Being alone, in particular, is experienced as more negative on average than being with others, in both normative and pathological populations. This study investigates whether daily solitude is associated with changes in cortisol and, if so, whether momentary and trait affect can explain this relationship. Forty-four female college students used the Experience Sampling Method during a week, completing questionnaires and collecting saliva 8 times daily. Effects of current solitude, affect, and trait affectivity on cortisol were tested with multilevel regression. Cortisol levels were significantly higher when individuals were alone. Although momentary affective states changed during solitude and were also associated with cortisol, they did not fully explain the effects of solitude on cortisol. Trait affectivity moderated the association between solitude and cortisol. Findings may help clarify how daily experience may heighten risk of depression or other negative health outcomes in vulnerable individuals.     

Relationships between daily stress responses in everyday life and nightly sleep

Stress and sleep are related, but the nature and time course of this relation is not well understood. We explored the within-person associations of three components of emotional responses to everyday stressors, indexed by negative affect, reactivity (initial response to a stressor), recovery (persistence of the post-stressor response), and pile-up (accumulation of stress episodes), with sleep indicators. We conducted coordinated analyses of data in several studies employing ecological momentary assessments, which captured naturally occurring, self-reported stress and sleep. We defined proximal reactivity as the emotional response to the stressor moment in question compared to an immediate pre-stressor state, and distal reactivity as the emotional response to the stressor moment in question compared to a typical stressor-free state for that person. Results in two of three studies showed that people reported significantly lower sleep quality following days on which they experienced higher levels of distal reactivity to stressors. Days with greater distal reactivity also predicted significantly more difficulty falling asleep in one of two studies. There was no clear association between proximal reactivity and subsequent sleep. Associations of recovery or pile-up with subsequent sleep emerged only in single studies. Poorer sleep quality was significantly related to higher next day levels of negative affect in all three studies, but there were no consistent relations between sleep and next day stress reactivity, recovery, or pile-up. These exploratory analyses suggest that distal reactivity is associated with a heightened risk of experiencing poor sleep quality the following night, and as such the former may serve as a candidate for potential targets for the remediation of the negative effects of stress on sleep.

     

The relation between daily stress and Crohn's disease

This study examined the effect of minor daily stressors on the primary indices of Crohn's disease in 10 adult volunteers from a support group for individuals with inflammatory bowel disease. All subjects monitored the occurrence of daily stress concurrently with the signs and symptoms of their disease for 28 days. The results of the regression and between-subject analyses indicate a relation between daily stress and self-rated disease severity in Crohn's disease. The effects of daily stress on signs and symptoms of Crohn's disease were significant even after controlling for the effects of major life events. Individual within-subject correlations, however, indicated that stress and indicators of disease were highly related for only three subjects. The results of the current study therefore suggest that at least for some individuals with Crohn's disease, daily stress is related to self-reported indicators of the illness.     

The effects of social stress and cortisol responses on the preconscious selective attention to social threat

The purpose of the present study was to investigate the effects of social stress and stress-induced cortisol on the preconscious selective attention to social threat. Twenty healthy participants were administered a masked emotional Stroop task (comparing color-naming latencies for angry, neutral and happy faces) in conditions of rest and social stress. Stress was induced by means of the Trier social stress test. Based on the stress-induced increase in cortisol levels, participants were allocated post hoc (median-split) to a high and low responders group. In contrast to low responders, high responders showed a negative or avoidant attentional bias to threat (i.e. shorter latencies for angry than neutral faces) in the rest condition. Most importantly, although low responders became avoidant, the high responders became vigilant to the angry faces after stress induction. There were no such effects for happy faces. Our findings are in line with previous studies in both animals and humans, that associate high glucocorticoid stress-responsiveness with diminished avoidance and prolonged freezing reactions during stress.     

Sex differences in physiological and affective responses to stress in remitted depression

Major depressive disorder (MDD) is associated with alterations in stress physiology. Severe melancholic depression is characterized by hypercortisolism, but community dwelling mildly depressed individuals and those with remitted MDD have shown reduced or normal reactivity to stress. There are also pronounced sex differences both in the incidence of MDD and in stress reactivity. To explore the relationships among depression history, sex differences, and stress, we examined stress reactivity in people with and without a history of MDD. Twenty-two participants with remitted MDD (12 men and 10 women) and 36 never depressed comparison participants (22 men and 14 women) participated in the study. Cortisol and alpha-amylase (sAA) were sampled from saliva before, 10 min after, and 30 min after the Trier Social Stress Test (TSST). Participants filled out the Positive Affect Negative Affect Schedule (PANAS) before and after they underwent the TSST. Women with remitted MDD showed reduced cortisol response to the TSST compared with the never MDD women, while men with remitted MDD showed comparable cortisol reactivity to the never depressed men. The groups did not differ on sAA reactivity to stress. The remitted MDD group (overall and men and women separately) reported greater negative affect both before and after stress compared to the never depressed group. Women from both groups reported greater post-stress negative affect than men. In contrast, men from both groups reported higher positive affect before and after stress than women. Given that the sex difference findings were not dependent on depression history, self-reported affective differences in response to stress may predate depressive symptoms and contribute to sex differences in depression incidence.     

Differential hormonal and physiological responses to stress in Roman high- and low-avoidance rats

In the present experiments, plasma concentrations of corticosterone, ACTH, prolactin, blood glucose, serum free fatty acids, core temperature and fecal boli were measured immediately following the exposure of Roman high- and low-avoidance rats (RHA/Verh, RLA/Verh) to various stressful situations. As compared to RLA/Verh rats, the RHA/Verh animals showed an attenuated emotional response in “non-self-menacing” (novel environment) situations. Differences between the 2 selected lines were not generally found in unstressed rats or in “high-stress” (ether, immobilisation, footshock) situations.     

The effects of adult attachment and life stress on daily depression: a sample of Japanese university students

To investigate the relationship among adult attachment style, life stress, and daily depression, a sample of 437 undergraduate students was prospectively studied. Insecure adult attachment and perceived life stress were related to their daily depressive mood. Further analyses using both multiple hierarchical regression and structural equation models (SEM) demonstrated that adult attachment style and perceived life stress independently predicted depression and had no interactive effects on daily depression. The impact of adult attachment on depression was not contingent upon the presence of life stress and securely attached participants were less impacted by depression than insecurely attached ones. These results suggest that adult attachment can play an important role in mental health intervention and may be helpful when it comes to preventing and treating depression. © 2009 Wiley Periodicals, Inc. J Clin Psychol 65: 1–14, 2009.     

Exhaustion and endocrine functioning in clinical burnout: an in-depth study using the experience sampling method

The current study investigates the relationship between HPA-axis functioning and burnout symptoms by employing an electronic symptom diary. This diary method circumvents the retrospection bias induced by symptom questionnaires and allows to study relationships within-in addition to between-subjects. Forty two clinically burned-out participants completed the exhaustion subscale of the Maslach burnout inventory and kept an electronic diary for 2 weeks to assess momentary exhaustion and daily recovery through sleep. On 3 consecutive weekdays within the diary period, saliva was sampled to determine the cortisol awakening response (CAR), levels of dehydroepiandrosterone-sulphate (DHEAS) on the first 2 weekdays, and to conduct the dexamethasone suppression test (DST) on the third weekday. We found significant relationships between endocrine values and general momentary symptom severity as assessed with the diary, but not with the retrospective questionnaire-assessed burnout symptoms. Simultaneous assessments of endocrine values and burnout symptoms assessed with the diary after awakening rendered significant associations between persons, and a trend within persons. More severe burnout symptoms were consistently associated with a lower level and smaller increase of CAR, higher DHEAS levels, smaller cortisol/DHEAS ratios and a stronger suppression after DST. Burnout symptoms were significantly related to endocrine functioning in clinical burnout under the best possible conditions of symptom measurement. This adds support to the view that severity of burnout symptoms is associated with HPA-axis functioning.     

Mood disorders in everyday life: A systematic review of experience sampling and ecological momentary assessment studies

In the past two decades, the study of mood disorder patients using experience sampling methods (ESM) and ecological momentary assessment (EMA) has yielded important findings. In patients with major depressive disorder (MDD), the dynamics of their everyday mood have been associated with various aspects of their lives. To some degree similar studies have been conducted in patients with bipolar disorder (BD). In this paper we present the results of a systematic review of all ESM/EMA studies in MDD and BD to date. We focus not only on the correlates of patients' everyday mood but also on the impact on treatment, residual symptoms in remitted patients, on findings in pediatric populations, on MDD/BD specificity, and on links with neuroscience. After reviewing these six topics, we highlight the benefits of ESM/EMA for researchers, clinicians, and patients, and offer suggestions for future studies.     

Hormonal responses to physical and cognitive stress in a school setting

Little is known about the influence of physical and cognitive stress on the concentration of steroid hormones (SHs) in a school setting. Forty high school students from the 9th grade were randomly assigned to two intervention groups: physical and cognitive stress. Saliva collection took place before (pre-test) and after (post-test) 12 min of high intensity exercise in a defined heart rate (HR) interval (70–85% HR _max; n = 19) and cognitive testing (Letter Digit Span and d2-test, n = 21), respectively. Saliva was analyzed for testosterone (T) and cortisol (C). Results indicated a significant increase of T and C due to a physical but not cognitive stressor. Thus, only the physical stressor was capable of activating the hypothalamic–pituitary–adrenal (HPA) and the hypothalamic–pituitary–gonadal (HPG) axis.     

补中益气汤加味改善压力性尿失禁患者生存质量的研究

目的评估补中益气汤加味改善压力性尿失禁（SUI）患者生存质量的效果。方法将58例女性压力性尿失禁患者随机分为A组和B组,采用两阶段交叉设计,A组先行运动疗法后服用中药,B组先服用中药后行运动疗法,比较分析两组治疗后的疗效。结果两组受试者的年龄、体重指数（BMI）、病程、怀孕生育次数及经产史、Gullen分度、中医证型分布差异无统计学意义（P〉0.05）;第一阶段治疗后,运动组的失禁程度、ICI-Q-SF、I-QOL评分在治疗前后差异有统计学意义（P〈0.05）,失禁频率和夜尿次数差异无统计学意义（P〉0.05）;中药组的各项指标在治疗前后差异有统计学意义（P〈0.05）;疗效评价：两种治疗方法治疗后两组的失禁频率、失禁程度、夜尿次数差异有统计学意义（P〈0.01）,两种治疗方法间ICI-Q-SF、I-QOL评分差异均有统计学意义（P〈0.01）。结论补中益气汤加味与盆底肌运动法都是治疗SUI的有效方法,补中益气汤加味治疗SUI较盆底肌运动法疗效更佳,并且能更好的改善SUI患者的生存质量。     

A daily stress inventory: Development,reliability, and validity

This article describes the development of the Daily Stress Inventory, a measure introduced to provide researchers and clinicians with a psychometrically sound self-report instrument for the daily assessment of the sources and individualized impact of relatively minor stressful events. It was designed to assess sources of stress not typically assessed by major life-event scales. Generalizability coefficients indicate that the scale has significant homogeneity and a useful degree of stability. Several studies investigating the concurrent and construct validities suggest that the scale measures the construct commonly referred to as "stress." Implications for uses in theoretical and basic research as well as clinical assessment are discussed.     

Stress-buffering effects of psychosocial resources on physiological and psychological stress response in pregnant women

Sixty healthy pregnant women (aged 21-35 years), including 30 pregnant women at the beginning of second trimester and 30 women at the beginning of third trimester underwent a psychosocial stress test. Physiological (salivary free cortisol levels, salivary alpha-amylase levels) and psychological (perceived stress, mood, anxiety) responses to standardized psychosocial stress have been brought in association with psychosocial resources (self-efficacy and daily uplifts). Predictions revealed that higher resources predict lower physiological and psychological stress responses and higher mood levels. We conclude from our data that psychosocial resources appear to dampen psychological and physiological stress response during pregnancy.