Department of Psychology, University of Denver, Denver, Colorado 80208, USA.
Biol Psychiatry. 2010 Sep 1;68(5):484-90. doi: 10.1016/j.biopsych.2010.04.004. Epub 2010 May 23.
Most depressed adults exhibit dysregulation of the hypothalamic-pituitary-adrenal axis, including cortisol hyperreactivity to psychosocial challenge. In contrast, remarkably little is known about hypothalamic-pituitary-adrenal axis activity in response to psychosocial challenge among at-risk children and adolescents. This study examined cortisol response to psychosocial challenge in nondepressed, at-risk, dysphoric and nondysphoric control youth across different developmentally salient age groups (preschool, third-, sixth-, and ninth-graders).
Two samples of youth (Study 1-preschoolers; Study 2-third-, sixth-, and ninth-graders) without a history of clinical depression were administered developmentally appropriate psychosocial challenges. Of these nondepressed children, we examined youth at high-risk (n = 60) and low-risk (n = 223) status, as defined by elevated but subthreshold dysphoric symptoms according to multiple informants. Cortisol levels were assessed before and after a psychosocial stressor.
Nondysphoric control youth at all ages displayed the expected cortisol rise to challenge followed by return to baseline. However, prepubertal, at-risk, dysphoric children--specifically preschoolers and third-graders--exhibited cortisol hyporeactivity to challenge, whereas postpubertal dysphoric adolescents (ninth-graders) displayed hyperreactivity to the stressor. Additional analyses revealed that this switch from cortisol hyporeactivity to hyperreactivity among at-risk, dysphoric youth occurred as a function of pubertal development.
Findings suggest a developmental switch in cortisol response for at-risk, dysphoric youth from preschool through adolescence and have implications for a developmental pathophysiological understanding of how at-risk youth across the lifespan might develop depressive disorder.
大多数抑郁的成年人表现出下丘脑-垂体-肾上腺轴的失调，包括皮质醇对心理社会挑战的过度反应。相比之下，对于有风险的儿童和青少年对心理社会挑战的下丘脑-垂体-肾上腺轴活动，人们知之甚少。本研究考察了无抑郁、有风险、情绪低落和无情绪低落的对照青少年在不同发育重要年龄组（学龄前、三年级、六年级和九年级）中对心理社会挑战的皮质醇反应。
两个没有临床抑郁病史的青少年样本（研究 1-学龄前儿童；研究 2-三年级、六年级和九年级学生）接受了适合其发育的心理社会挑战。在这些无抑郁的儿童中，我们根据多个信息来源，检查了高风险（n=60）和低风险（n=223）状态的儿童，定义为情绪低落但处于亚阈值水平的儿童。皮质醇水平在心理社会应激源前后进行评估。
所有年龄段的无情绪低落的对照青少年在受到挑战后都表现出预期的皮质醇升高，随后恢复到基线。然而，青春期前、有风险、情绪低落的儿童，特别是学龄前儿童和三年级儿童，对挑战表现出皮质醇反应低下，而青春期后情绪低落的青少年（九年级）对压力源表现出皮质醇过度反应。进一步的分析表明，这种有风险、情绪低落的青少年皮质醇反应从反应低下到过度反应的转变是随着青春期发育而发生的。
研究结果表明，有风险、情绪低落的青少年从学龄前到青春期，皮质醇反应出现了发育性转变，这对理解整个生命周期中处于风险中的青少年如何可能发展为抑郁症的发展性病理生理学有影响。
