Clemens Kirschbaum

TU Dresden | TUD · Department of Psychology

Background: Pediatric major depressive disorder (MDD) represents a leading cause of disability worldwide in children and adolescents, while its underlying pathophysiology remains largely elusive. The endocannabinoid system (ECS) and the hypothalamus-pituitary-adrenal (HPA) axis are considered intertwined regulatory systems crucially implicated in t...

Objective This study investigates the mediating role of rumination in the relationship between work-related stress and sleep quality. Sleep quality is a critical component of mental health and wellbeing. Work-related stress is a potential risk factor for poor sleep quality, and this research focuses on how the constructs of rumination—affective rum...

Cell deformability of all major blood cell types is increased in depressive disorders (DD). Furthermore, impaired glucocorticoid secretion is associated with DD, as well as depressive symptoms in general and known to alter cell mechanical properties. Nevertheless, there are no longitudinal studies examining accumulated glucocorticoid output and dep...

Background The emergence of the COVID-19 pandemic rapidly accelerated the need and implementation of digital innovations, especially in medicine. Objective To gain a better understanding of the stress associated with digital transformation in physicians, this study aims to identify working conditions that are stress relevant for physicians and dif...

Background: While available posttraumatic stress disorder (PTSD) treatments are generally successful, 30-40% of patients show limited improvement. The endocannabinoid system may play a role in the aftermath of trauma, in PTSD, and in extinction processes. Therefore, this secondary analysis of a randomized-controlled trial including PTSD inpatients...

Background Adverse life events and chronic psychological distress before and during pregnancy have frequently been associated with preterm birth (PTB) but the biological underpinnings remain unclear. We investigated the association between corticosteroid levels in pre-pregnancy and first-trimester hair and the risk of PTB. Methods We followed 1,80...

Background Patients with panic disorder (PD) show alterations of the immune reactivity to acute stress, which could serve as a marker for effective treatment. Nevertheless, the effect of immune reactivity under acute stress before treatment on therapy outcome remains unclear. Methods A total of N = 16 PD patients performed the Trier Social Test. B...

Assessing factors that influence chronic stress biomarkers like hair cortisol concentrations (HCCs) in pregnancy is critical to prevent adverse pregnancy outcomes. Thus, we aimed to identify correlates of HCC preconception and during pregnancy. 2,581 pregnant women participated in the study. HCC was available at four time periods: pre-pregnancy (0–...

Background: Cortisol is one of the most extensively studied biomarkers in the context of trauma/posttraumatic stress disorder (PTSD). For more than a decade, hair cortisol concentrations (HCC) have been measured in this context, leading to a two-staged dysregulation model. Specifically, an elevated secretion during/immediately after trauma exposur...

Severe coronavirus disease 2019 (COVID-19) is associated with hyperinflammation, hypercoagulability and hypoxia. Red blood cells (RBCs) play a key role in microcirculation and hypoxemia and are therefore of special interest in COVID-19 pathophysiology. While this novel disease has claimed the lives of many older patients, it often goes unnoticed or...

BACKGROUND The emergence of the COVID-19 pandemic rapidly accelerated the need and implementation of digital innovations, especially in medicine. OBJECTIVE To gain a better understanding of the stress associated with digital transformation in physicians, this study aims to identify working conditions that are stress relevant for physicians and dif...

Some retrospective studies suggest that psychosocial stressors trigger the onset of tics. This study examined prospective hypothalamic–pituitary–adrenal (HPA) axis activity and perceived stress prior to tic onset. In the present study, 259 children at high risk for developing tics were assessed for hair cortisol concentration (HCC) and parent-on-ch...

Background: Traumatic events, including child abuse and intimate partner violence, are highly prevalent among women of child-bearing age. These traumatic experiences may impact maternal and offspring physical and mental health. A proposed mechanism for these effects is maternal hypothalamic-pituitary-adrenal (HPA) axis dysregulation which can be m...

Purpose: Stress and elevated maternal glycemia have negative effects on pregnancy. We evaluated the association of hair cortisol concentrations (HCC), a marker of chronic stress, with insulin resistance and gestational diabetes (GDM). Methods: 527 women from Lima, Peru, provided a hair sample in the second trimester of their pregnancy to measure...

PTSD patients show alterations of the immune system, mainly a ‘low-grade inflammation’. Psychotherapeutic treatments are meant to reduce symptom burden of PTSD patients but 30–50% of PTSD patients do not benefit from psychotherapy. Therefore, in this study, the predictive effect of cytokine levels on therapy outcome are investigated. Pro- (IL-6) an...

Background Childbirth-related posttraumatic stress disorder (CB-PTSD) is gaining attention as a mental disorder with negative sequelae for mothers and their offspring. Maternal trauma history is a well-known vulnerability factor for CB-PTSD symptoms (CB-PTSS). Furthermore, alterations of the hypothalamus-pituitary-adrenal axis have been linked to b...

Background: The endocannabinoid system (ECS) is increasingly being recognized as key regulatory system coupled with the glucocorticoid system implicated in the pathophysiology of major depressive disorder (MDD). However, prior studies examining the ECS in MDD have been inconclusive, of small sample size or of cross-sectional nature limiting interpr...

Background Maternal symptoms of depression constitute an early adversity for infants that is considered to exert its effects via the maternal-placental-fetal neuroendocrine axis. Previous research implicates associations between maternal prenatal symptoms of depression and infants’ glucocorticoid (GC) levels shortly after birth. To date, associatio...

Background: Cell deformability of all major blood cell types is increased in depressive disorders (DD). Furthermore, impaired glucocorticoid secretion is causally related to DD. Nevertheless, there are no longitudinal studies examining changes in glucocorticoid output and depressive symptoms regarding cell deformability in DD. Aim: To investigate,...

The cortisol awakening response (CAR) is frequently assessed in psychobiological (stress) research. Obtaining reliable CAR data, however, requires careful attention to methodological detail. To promote best practice, expert consensus guidelines on the assessment of the CAR were published (Stalder et al., 2016, PNEC). However, it is unclear whether...

Patients suffering from social anxiety disorder (SAD) fear social interaction and evaluation, which severely undermines their everyday life. There is evidence of increased prosocial behavior after acute social stress exposure in healthy individuals, which may be interpreted as stress-regulating “tend-and-befriend” behavior. In a randomized controll...

Stress-related exhaustion symptoms have a high prevalence which is only likely to increase further in the near future. Understanding the physiological underpinnings of exhaustion has important implications for accurate diagnosis and the development of effective prevention and intervention programs. Given its integrative role in stress-regulation, t...

This is a Poster on a Pre-post evaluation of a psychological help program during the COVID-19 pandemic to reduce depressive, anxiety and somatic symptoms.

Background The study aimed to investigate the link between burnout symptoms and prosocial behaviour, as well as the role of acute stress and vagally-mediated heart rate variability (vmHRV) on this association. Methods Seventy men were randomly assigned to either the stress or the control condition of the Trier Social Stress Test for Groups (TSST-G...

Background There is clear evidence that tic disorders (TDs) are associated with psychosocial stress as well as emotional and behavioral problems. Studies have shown that individuals with TDs have higher acute physiological stress responses to external, single stressors (as reflected by saliva cortisol). The aim of the present study was to examine a...

Pathophysiological landmarks of depressive disorders are chronic low-grade inflammation and elevated glucocorticoid output. Both can potentially interfere with cytoskeleton organization, cell membrane bending and cell function, suggesting altered cell morpho-rheological properties like cell deformability and other cell mechanical features in depres...

Antenatal synthetic glucocorticoid (sGC) treatment is a potent modifier of the hypothalamic-pituitary-adrenal (HPA) axis. In this context, epigenetic modifications are discussed as potential regulators explaining how prenatal exposure to GCs might translate into persistent changes of HPA axis “functioning”. The purpose of this study was to investig...

Although the link between androgens and depression is well established in adults, the effects of cofactors on this association are less clearly understood, particularly in youth. Epidemiological cohort study of adolescents in Dresden, Germany. Analyses comprised data of 985 individuals assessed at baseline and of 512 individuals at 1-year follow-up...

Not only males but also females compete over reproduction. In a population of free-living house mice (Mus musculus domesticus), we analyzed how (metabolic) costs of aggressive interactions (reflected in fresh wounds and long-term corticosterone concentrations in hair) are predicted by individual reproductive physiology and reproductive success in m...

Aim Individuals with schizophrenia demonstrate higher rates of metabolic syndrome (MetS) than the general population. Hair cortisol concentrations (HCC) reflect longer-term cortisol secretion and can provide additional insights into the role of the hypothalamic pituitary adrenal (HPA) axis in schizophrenia and co-occurring MetS. Methods In a case–...

Glucocorticoids and inflammatory markers can influence cognitive function. Hair cortisol concentrations (HCC) reflect longer-term hypothalamic pituitary adrenal (HPA) axis function and combined with immune markers can provide insight into how HPA-axis and immune pathways interact to influence cognition. We examined the association between HCC and h...

Acute psychosocial stress has been shown to impair memory and cognitive control in young adults. So far, only very little empirical research is available concerning possible adult age differences in acute stress effects on cognition in general and cognitive control in particular. Accordingly, the present study set out to test these effects in a con...

The abilities to monitor one’s actions and novel information in the environment are crucial for behavioural and cognitive control. This study investigated the development of error and novelty monitoring and their electrophysiological correlates by using a combined flanker with novelty-oddball task in children (7–12 years) and adolescents (14–18 yea...

Background While cognitive-behavioral therapy (CBT) is the gold-standard psychological treatment for major depression (MD), non-response and lacking stability of treatment gains are persistent issues. Potential factors influencing treatment outcome might be lifetime trauma history and possibly associated primarily prefrontal-cortex- and hippocampus...

Introduction Many adults, adolescents and children are suffering from persistent stress symptoms in the face of the COVID-19 pandemic. This study aims to characterize long-term trajectories of mental health and to reduce the transition to manifest mental disorders by means of a stepped care program for indicated prevention. Methods and analysis Us...

Background Although the link between androgens and depression is well established in adults, the effect of cofactors on this association are less clearly understood in youth. Methods Epidemiological cohort study of adolescents in Dresden, Germany. Analyses comprised data of 985 individuals assessed at baseline (512 individuals at follow-up). We in...

Background: The endocannabinoid system (ECS) is increasingly being recognized as key regulatory system coupled with the glucocorticoid system implicated in the pathophysiology of stress-related mental disorders. However, prior studies examining the ECS in depression or burnout have been inconclusive, of small sample size or of cross-sectional natur...

Hair analysis of endocannabinoids and N-acylethanolamines presents a promising methodological advancement for the retrospective assessment of long-term cumulative endocannabinoids and N-acylethanolamines secretion over extended periods of time. A main assumption of this method application that hair endocannabinoid and N-acylethanolamine concentrati...

Objective: To investigate the effect of regular contemplative mental training on endocrine and psychological indices of long-term stress. Methods: An open-label efficacy trial that comprised three distinct 3-month modules targeting attention and interoception, socio-affective or socio-cognitive abilities through dyadic exercises and secularised...

Background. Pathophysiological landmarks of depressive disorders are chronic low-grade inflammation and elevated glucocorticoid output. Both can potentially interfere with cell membrane bending and cell function, suggesting altered cell morpho-rheological properties like cell deformability and other cell mechanical features in depressive disorders....

Accidents caused by human errors illustrate the fragility of cognitive processing and its coordination by executive functions against stress. To better understand how core executive functions change over time, influence each other, and are affected by chronic stress exposure, a prospective cohort study was conducted from 2016 to 2019. Five hundred...

Differences in moral judgements are associated with various factors, including biological parameters. Previous studies have—albeit inconsistently—reported a stronger tendency towards utilitarian judgements in men. Utilitarian judgements are situation-dependent, outcome-based, and favor the ‘greater good’. In contrast, deontological judgements are b...

Psychological treatments of posttraumatic stress disorder (PTSD) are associated with non-response rates of up to 50%. This fact highlights the need to identify characteristics of poorer treatment outcome. Among others, previous evidence focused on the role of dysfunctional cortisol secretion which has been related to the development, maintenance an...

Background: Glucocorticoid (GC) administration prior to exposure-based cognitive-behavioural therapy (CBT) has emerged as a promising approach to facilitate treatment outcome in anxiety disorders. Further components relevant for improved CBT efficacy include raised endogenous GCs and reductions in information-processing biases to threat. Aims: T...

For poor sleep quality (SQ) as well as major depressive disorder (MDD) and burnout, a dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis has been identified. Although poor SQ is often reported as an early symptom of MDD or burnout, it is not clear whether HPA axis-related hormones can influence the association between SQ and MDD or burn...

Objectives Most of the observed associations of generalized anxiety disorder (GAD), social anxiety disorder (SAD) and major depressive disorder (MDD) with cortisol concentrations came from clinical and adult study samples, with inconsistent findings, partly due to method variance. We examined cross-sectional and longitudinal associations between GA...

Aside from cultural, psychological, or situational factors, differences in moral judgements might also be influenced by biological variables. Since previous studies have reported stronger utilitarian tendencies in men, the relationship between testosterone and moral judgments has gained interest. Utilitarian judgements focus on the consequences of...

While there are many different methods for peak detection, no automatic methods for marking peak boundaries to calculate area under the curve (AUC) and signal-to-noise ratio (SNR) estimation exist. An algorithm for the automation of liquid chromatography tandem mass spectrometry (LC-MS/MS) mass chromatogram quantification was developed and validate...

Background The endocannabinoid system has been suggested to modulate energy metabolism and stress response and could be an important factor in the pathophysiology of anorexia nervosa (AN). In the context of AN, excessive physical activity may influence endocannabinoid concentrations. The objective of this study was to investigate hair endocannabino...

In order to understand the psychopathology of the social anxiety disorder (SAD) at the neuroendocrine level, standardized experimental studies on endocrine and physiological markers are necessary, especially since empirical data are still ambiguous. Hence, differences in both, the autonomic nervous system (ANS) and the endocrine stress responses (A...

Background The development and maintenance of anxiety disorders is not fully understood. There is consensus in the literature that in addition to genetic factors, social, psychological and neurobiological factors are of crucial importance. The present exploratory study investigates the influence of the endocannabinoids (EC) and related N-acylethano...

Objective This study had the objective to investigate the effect of regular contemplative mental training on endocrine indices of long-term stress. Methods An open-label efficacy trial comprising three distinct 3-month modules targeting attention and interoception, socio-affective or socio-cognitive abilities through dyadic exercises and secularis...

There is growing evidence that humans use olfactory chemosensory signals for social communication, but their role in affective associative learning is largely unknown. To examine this, women implicitly learned face-odor associations by pairing different neutral male faces with either a male chemosignal presumably involved in human mating behavior (...

Since previous studies have reported stronger utilitarian tendencies in men, the relationship between testosterone and moral judgments has gained interest. Utilitarian judgements focus on the consequences of actions in terms of a cost-benefit analysis while deontological judgements are based on rules that are independent of an action’s outcome or o...

Objectives. Burnout is a stress-related, psychological syndrome due to high levels of job stressors. It has been found to be related to impairments of well-being, health, and job outcomes. Alterations of glucocorticoid secretion might be a mechanism explaining the linkage between burnout and reduced psychophysical functioning. Regarding hair cortis...

Objectives: The association between depressive symptomatology and endogenous testosterone levels is inconclusive. Large inter- and intra-individual testosterone differences suggest point measurements from saliva or serum to be inadequate to map basal testosterone concentrations highlighting the potential for long-term integrated testosterone levels...

Prior studies identified DNA methylation (DNAM) changes in a regulatory region within the FK506 binding protein 5 (FKBP5) gene as a crucial mediator of long-term negative health outcomes following early adversity. A critical mechanism underlying this link, in turn, has been suggested to be epigenetically induced dysregulation of the hypothalamic–pi...

Although substantial evidence suggests altered executive functioning and autobiographical memory in posttraumatic stress disorder (PTSD), the clinical significance of these findings remains unclear. Here, we investigated the effects of cognitive-behavioral therapy (CBT) on different aspects of cognitive functioning (working memory, interference sus...

Occupational stress management intervention programs are known to be effective in preventing stress-related health burden. Two essential mechanisms underlie this effect: (i) a reduction in perceived stress (e.g., via relaxation-oriented techniques), and (ii) an improvement in coping skills (e.g., via cognitive-behavioral interventions). While relax...

Background Parkinson’s disease (PD) and metabolic syndrome (MetS) share certain pathophysiological pathways, including hypothalamic pituitary adrenal (HPA) axis dysfunction. Hair glucocorticoid (GC) levels reflect longer-term HPA-axis function and can provide additional insights into the role of a dysregulated HPA-axis in PD and co-occurring cardio...

The endocannabinoid system has been implicated in the dynamic regulation of the stress response, fear memory formation, and inflammatory processes. Endocannabinoids (eCBs) and N-acylethanolamines (NAEs) are primarily quantified from serum or cerebrospinal fluid representing acute measures, while no validated method for the quantification of long-te...

Altered activity of the endocannabinoid (EC) system has been linked to dysregulated stress-reactivity and the development of trauma-related psychopathology. The EC system, with its main components anandamide (AEA), 2-arachidonoyl-glycerol (2-AG) and other N-acyl-ethanolamides, is considered to be a buffer system that protects against the negative e...

Background Functional connectivity is a fundamental principle of brain organization. Cortisol, the end product of the hypothalamic–pituitary–adrenal axis, is a potent modulator of brain functions. Previous studies investigating the association between cortisol levels on brain connectivity are, however, limited to specifica priori defined brain netw...

It is debated as to whether major depressive disorder (MDD) and the burnout syndrome represent different aspects of the same syndrome or whether they reflect separate entities. A dysregulation of the hypothalamus-pituitary-adrenal-axis has been related to both conditions separately. Dissecting the pathophysiology of the conditions and describing di...