Department of Mental Disorder Research, National Institute of Neuroscience, National Center of Neurology and Psychiatry, 4-1-1, Ogawahigashi, Kodaira, Tokyo, 187-8502, Japan.
J Psychiatr Res. 2010 Oct;44(14):865-73. doi: 10.1016/j.jpsychires.2010.02.007. Epub 2010 Mar 23.
Psychological distress and coping styles have been suggested to relate to altered function in the hypothalamic-pituitary-adrenal (HPA) axis, although there remains much to be understood about their relationships. High and low cortisol levels (or reactivity) both represent HPA axis dysfunction, with accumulated evidence suggesting that they are linked to different types of psychopathology. The dexamethasone (DEX)/corticotropin-releasing hormone (CRH) test has been extensively used to identify HPA axis abnormalities in various psychiatric conditions including mood disorders; however, the possible associations of psychological distress and coping styles with HPA axis function have not been well documented using this test. Here, we examined the relationships of HPA axis reactivity as measured by the DEX/CRH test with subjectively perceived psychological distress and coping styles, both of which were assessed with self-report questionnaires, in 121 healthy volunteers. Subjects were divided into three groups by the cortisol suppression pattern, namely the incomplete-suppressors (DST-Cortisol ≥ 5 μg/dL or DEX/CRH-Cortisol ≥ 5 μg/dL), moderate-suppressors (DST-Cortisol < 5 μg/dL and 1 μg/dL ≤ DEX/CRH -Cortisol < 5 μg/dL), and enhanced-suppressors (DST-Cortisol < 5 μg/dL and DEX/CRH-Cortisol < 1 μg/dL). The enhanced-suppressors showed significantly higher scores in obsessive-compulsive, interpersonal sensitivity and anxiety symptoms and significantly more frequent use of avoidant coping strategy, compared to the other two groups. These results point to the important role of enhanced suppression of cortisol, or blunted cortisol reactivity, in non-clinical psychopathology such as avoidant coping strategy and greater psychological distress.
心理困扰和应对方式被认为与下丘脑-垂体-肾上腺（HPA）轴的功能改变有关，尽管它们之间的关系仍有许多需要了解。高皮质醇和低皮质醇（或反应性）水平都代表 HPA 轴功能障碍，越来越多的证据表明它们与不同类型的精神病理学有关。地塞米松（DEX）/促肾上腺皮质激素释放激素（CRH）测试已广泛用于识别各种精神疾病（包括心境障碍）中的 HPA 轴异常；然而，使用这种测试，心理困扰和应对方式与 HPA 轴功能的可能关联尚未得到很好的记录。在这里，我们研究了 121 名健康志愿者的 DEX/CRH 测试测量的 HPA 轴反应性与主观感知的心理困扰和应对方式之间的关系，这两种方法均通过自我报告问卷进行评估。根据皮质醇抑制模式将受试者分为三组，即不完全抑制组（DST-皮质醇≥5μg/dL 或 DEX/CRH-皮质醇≥5μg/dL）、中度抑制组（DST-皮质醇<5μg/dL 且 1μg/dL≤DEX/CRH-皮质醇<5μg/dL）和增强抑制组（DST-皮质醇<5μg/dL 和 DEX/CRH-皮质醇<1μg/dL）。与其他两组相比，增强抑制组在强迫、人际关系敏感和焦虑症状方面的得分明显更高，回避应对策略的频率也明显更高。这些结果表明，皮质醇抑制增强或皮质醇反应性降低在非临床精神病理学中（如回避应对策略和更大的心理困扰）起着重要作用。
