Sobrinho L G, Simões M, Barbosa L, Raposo J F, Pratas S, Fernandes P L, Santos M A
Department of Endocrinology, Portuguese Cancer Institute, 1099-023 Lisbon, Portugal.
Psychoneuroendocrinology. 2003 Jan;28(1):1-17. doi: 10.1016/s0306-4530(01)00100-7.
The present study describes the responses of cortisol, prolactin and growth hormone (GH) to emotions elicited during sessions in which an hypnoidal state was induced. The purpose of the study was to provide answers for the following questions: 1) Do sessions with an emotional content have more hormonal surges than baseline, relaxation-only, sessions? 2) Does the induction of a fantasy of pregnancy and nursing elicit a prolactin response? 3) Are there any associations between surges of different hormones? 4) Are hormonal responses related to the intensity, type, or mode of expression of the emotions? For this purpose, thirteen volunteers and twelve patients with minor emotional difficulties were studied during sessions under hypnosis. The period of observation lasted for about three hours. Heart rate (HR), skin conductance (SC) and vagal tone (VT) were monitored. Serum cortisol, prolactin and growth hormone were sampled every 15 minutes. The volunteers had three types of sessions- "blank", consisting of relaxation only (12 sessions), "breast feeding", in which a fantasy of pregnancy and breast feeding was induced (12 sessions) and "free associations" in which the subjects were encouraged to evoke experiences or feelings (17 sessions). The patients had only sessions of free associations (38 sessions). Sessions of free associations had more hormonal surges than "blank" and "breast feeding" sessions. This was true for cortisol (8/17 v.3/24; p < 0.03), prolactin (7/17 v. 3/24; p < 0.05) and GH (9/17 v. 4/24; p < 0.02). During the 55 sessions of free associations (volunteers plus patients) there were 32 surges of cortisol, 18 of prolactin and 28 of GH. Cortisol and prolactin surges were negatively correlated (p < 0.03). GH had no significant association with either cortisol or prolactin. Visible emotions were positively associated with GH surges (p < 0.05). but not with cortisol or prolactin. Cortisol surges were correlated positively with evocations of real events (p < 0.01) and negatively with evocations containing defensive elements (p < 0.01). Cortisol correlated positively with shock and intimidation (p < 0.02) and negatively with rage (p < 0.04). The AUC of the cortisol peaks during shock and intimidation was significantly higher than that of the pool of all other cortisol peaks (12.4 micromol x min x l(-1) v. 7.1 micromol x min x l(-1); p < 0.005). Rage had a marginally significant positive association with prolactin surges (p=0.07). The distribution of GH surges did not show any significant association with types of emotions. The present study provides evidence that cortisol, prolactin and GH respond to psychological stress in humans. However, they are regulated differently from one another. Cortisol and prolactin surges appear to be alternative forms of response to specific emotions. GH surges depend on the intensity of the emotion, probably as a consequence of the associated muscular activity. The current paradigm of stress, implying corticotrophin-releasing hormone (CRH) as the initial step of a cascade of events, is insufficient to account for the diversity of hormonal changes observed in psychological stress in humans.
本研究描述了在诱导类催眠状态的过程中，皮质醇、催乳素和生长激素（GH）对所引发情绪的反应。该研究的目的是为以下问题提供答案：1）含有情感内容的时段相比仅为基线水平、仅放松的时段是否会引发更多的激素波动？2）诱导怀孕和哺乳的幻想是否会引发催乳素反应？3）不同激素的波动之间是否存在关联？4）激素反应是否与情绪的强度、类型或表达模式有关？为此，对13名志愿者和12名有轻微情绪问题的患者在催眠状态下进行了研究。观察期持续约三小时。监测心率（HR）、皮肤电导率（SC）和迷走神经张力（VT）。每15分钟采集一次血清皮质醇、催乳素和生长激素样本。志愿者有三种类型的时段——“空白”时段，仅包括放松（12个时段）；“母乳喂养”时段，诱导怀孕和母乳喂养的幻想（12个时段）；以及“自由联想”时段，鼓励受试者唤起经历或感受（17个时段）。患者仅有自由联想时段（38个时段）。自由联想时段比“空白”和“母乳喂养”时段引发更多的激素波动。皮质醇（8/17对3/24；p<0.03）、催乳素（7/17对3/24；p<0.05）和GH（9/17对4/24；p<0.02）均是如此。在55个自由联想时段（志愿者加患者）中，有32次皮质醇波动、18次催乳素波动和28次GH波动。皮质醇和催乳素波动呈负相关（p<0.03）。GH与皮质醇或催乳素均无显著关联。明显的情绪与GH波动呈正相关（p<0.05），但与皮质醇或催乳素无关。皮质醇波动与真实事件的唤起呈正相关（p<0.01），与包含防御性元素的唤起呈负相关（p<0.01）。皮质醇与震惊和恐吓呈正相关（p<0.02），与愤怒呈负相关（p<0.04）。在震惊和恐吓期间皮质醇峰值的曲线下面积显著高于所有其他皮质醇峰值的总和（12.4微摩尔×分钟×升⁻¹对7.1微摩尔×分钟×升⁻¹；p<0.005）。愤怒与催乳素波动有边缘显著的正相关（p = 0.07）。GH波动的分布与情绪类型未显示出任何显著关联。本研究提供了证据表明，皮质醇、催乳素和GH对人类的心理应激有反应。然而，它们彼此之间的调节方式不同。皮质醇和催乳素波动似乎是对特定情绪的替代反应形式。GH波动取决于情绪的强度，可能是相关肌肉活动的结果。当前将促肾上腺皮质激素释放激素（CRH）作为一系列事件的初始步骤的应激范式，不足以解释在人类心理应激中观察到的激素变化的多样性。
