Miller GE, Chen E, Zhou ES. If it goes up, must it comd down? Chronic stress and thet hypothalamic-puitary-adrenocortical axis in humans. Psychol Bull 113: 25-45

Department of Psychology, University of British Columbia (UBC), Vancouver, BC, Canada.
Psychological Bulletin (Impact Factor: 14.76). 02/2007; 133(1):25-45. DOI: 10.1037/0033-2909.133.1.25
Source: PubMed

ABSTRACT The notion that chronic stress fosters disease by activating the hypothalamic-pituitary-adrenocortical (HPA) axis is featured prominently in many theories. The research linking chronic stress and HPA function is contradictory, however, with some studies reporting increased activation, and others reporting the opposite. This meta-analysis showed that much of the variability is attributable to stressor and person features. Timing is an especially critical element, as hormonal activity is elevated at stressor onset but reduces as time passes. Stressors that threaten physical integrity, involve trauma, and are uncontrollable elicit a high, flat diurnal profile of cortisol secretion. Finally, HPA activity is shaped by a person's response to the situation; it increases with subjective distress but is lower in persons with posttraumatic stress disorder.

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Available from: Eric S. Zhou, Sep 29, 2015
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    • "However, in studies of ED, conflicting results showing increased, decreased or normal cortisol levels have been reported (Mommersteeg et al., 2006a, 2006b, 2006c), and recent studies of well-defined ED patients have failed to show deviating diurnal cortisol patterns compared to controls (Österberg et al., 2009; Österberg et al., 2012; Sjörs et al., 2012). One possibility is that the earlier stages of ED are characterized by increased levels of free cortisol, while later stages are associated with hypocortisolism, representing a breakdown of the endocrine feedback mechanisms (McEwen & Wingfield, 2003; Kudielka et al., 2006; Miller et al., 2007). In support of this, a review of 62 articles found that the cortisol awakening response (CAR) covaried positively with work stress and general life stress, while clinical burnout/exhaustion and fatigue were associated with reduced CAR (Chida & Steptoe, 2009). "
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    ABSTRACT: Prior findings indicate that individuals scoring high on vital exhaustion show a dysfunctional stress response (DSR), that is, reduced cortisol reactivity and habituation to psychosocial stressors. The main aim of the present study was to examine whether a DSR may be a vulnerability factor in exhaustion disorder (ED). We examined whether a DSR is present during the early stages of ED, and still is present after recovery. Three groups were studied: 1. Former ED patients (n = 14); 2. persons who during the past 6 month had experienced stress at work and had a Shirom–Melamed Burnout Questionnaire (SMBQ) score over 3.75, considered to indicate a pre-stage of ED (n = 17); 3. persons who had not experienced stress at work during the past 6 months and had a SMBQ score below 2.75 (n = 20). The participants were exposed twice to a virtual version of the Trier Social Stress Test (V-TSST), during which salivary cortisol samples were collected. In addition, high frequency heart rate variability (HF-HRV), heart rate (HR), t-wave amplitude (TWA), and α-amylase were assessed to examine stress reactivity and habituation in the autonomic nervous system (ANS).
    Physiology & Behavior 07/2015; 151. DOI:10.1016/j.physbeh.2015.07.020 · 2.98 Impact Factor
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    • "Both hypoand hypercortisolism have been seen in patients with posttraumatic stress disorder (PTSD) and depression. Both extremes can indicate HPA axis dysregulation (reviewed by Miller et al. 2007). "
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    ABSTRACT: Status hierarchies are universal across human and non–human animal social groups. Hormones and status interact with one another in a reciprocal manner. The present paper reviews the current literature on the interaction between testosterone (T), cortisol (C) and status in humans, with reference to non-human animal research. We discuss the complexity of the social neuroendocrinology of status with a focus on stable status, competitions for status, and the effects of severe social subjugation. Importantly, we conclude that the relationship between these hormones and status is not direct. We address moderators of the relationship between hormones and status, such as sex, individual differences, context, and T x C interactions, to get a more nuanced understanding of this relationship. Future directions include suggestions for examining this relationship longitudinally, including more females in status research, additional focus on social context and hormonal interactions, as well as non-competitive routes to status.
    06/2015; 1(2). DOI:10.1007/s40750-015-0025-5
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    • "Stressful experiences have been shown to alter the function of this system. For instance, exposure to life events has been suggested to reduce function of the HPA-axis in the long term [40]. Alterations in cortisol levels have been associated with FBS and functional somatic syndromes [10]. "
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    ABSTRACT: To test age- and sex-specific associations between adverse life events and functional bodily symptoms (FBS) in the general population. In a population-based cohort, 964 participants (mean age 55 years SD 11, 48% male) completed two measurements waves of the present study. Lifetime exposure to 12 adverse life events was assessed through a modified version of the List of Threatening Experiences. Stress-sensitive personality was assessed with the 12-item neuroticism scale of the Eysenck Personality Questionnaire-Revised. Socio-economic status was retrieved from questionnaires. Participants completed the somatization section of the Composite International Diagnostic Interview to survey the presence of 42 FBS in the previous year. Regression analyses, adjusted for age, revealed that lifetime scores of adverse life events were significantly associated with FBS in the previous year, an association that was nearly identical for females (beta=0.18, t=4.07, p<0.01) and males (beta=0.19, t=4.24, p<0.01). This association remained statistically significant when stress-sensitive personality and socio-economic status were added to the model. Associations between adverse life events during childhood and FBS were statistically significant in females (beta=0.13, t=2.90, p=0.04) but not in males (beta=0.06, t=1.24, p=0.22), whereas there was a stronger association with adverse life events during adulthood in males (beta=0.20, t=4.37, p<0.01) compared to females (beta=0.15, t=3.38, p=0.01). Life events in the previous year were not associated with FBS in the previous year. Adverse life events during lifetime were associated with FBS in the previous year. This association was dependent on age and sex but largely independent of having a stress-sensitive personality or low socio-economic status. Future studies could adopt a life course perspective to study the role of adverse life events in FBS. Copyright © 2015 Elsevier Inc. All rights reserved.
    Journal of psychosomatic research 05/2015; 79(2). DOI:10.1016/j.jpsychores.2015.05.013 · 2.74 Impact Factor
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