Department of Psychology, University of Denver.
Dev Psychopathol. 2011 Aug;23(3):881-896. doi: 10.1017/S095457941100037X.
Although the majority of research attention to the hypothalamic-pituitary-adrenal (HPA) axis in stress-related disorders and as a marker of allostatic load has focused on overactivation of this stress system, theory and data clearly indicate that underactivation is also an important type of dysregulation. In the current study we focused on low cortisol, exploring a constellation of risk factors including stress exposure, maternal depression, and attenuated basal and stress reactive cortisol in two samples of children. The first sample was comprised of 110 preschoolers living in high-stress environments. Cortisol was assessed across the day at home and at child care as well as across two stress paradigms. These data were used to classify whether children's HPA axis activity was attenuated. Serious family financial strain, maternal depression, and attenuated cortisol all made unique contributions in models predicting current clinical levels of internalizing symptoms as rated by mothers and teachers. The second sample was 166 third, sixth, and ninth graders studied five times across a 1-year period. Maternal and child depression were determined through structured clinical interviews, and stress exposure was assessed via checklist and interview techniques with the child and parent. Cortisol was assessed multiple times across a lab visit at Time 1, and these data were combined into a single continuous measure. Cortisol concentrations across the lab visit interacted with stress exposure across the year such that children with lower average cortisol at Time 1 and increased stress across the 12 months showed elevated levels of internalizing symptoms. Based on these and related data we propose that prior to puberty low cortisol may be an important marker of allostatic load, particularly for risk of depression and anxiety.
虽然大多数研究都关注下丘脑-垂体-肾上腺（HPA）轴在应激相关疾病中的作用，以及它作为适应负荷的标志物，但理论和数据清楚地表明，该应激系统的功能低下也是一种重要的失调类型。在当前的研究中，我们专注于皮质醇水平低的情况，探讨了一系列风险因素，包括应激暴露、产妇抑郁以及在两个儿童样本中皮质醇基础值和应激反应性降低。第一个样本由 110 名生活在高压力环境中的学龄前儿童组成。在家中和日托中心以及两个应激范式中评估了皮质醇的全天变化。这些数据用于分类儿童的 HPA 轴活动是否减弱。严重的家庭经济压力、产妇抑郁和皮质醇降低均对预测母亲和教师评定的当前内化症状的临床水平的模型做出了独特的贡献。第二个样本由 166 名三、六和九年级学生组成，他们在一年中接受了五次研究。通过结构化临床访谈确定了产妇和儿童的抑郁情况，通过儿童和家长的清单和访谈技术评估了应激暴露情况。在第 1 次实验室就诊时多次评估了皮质醇，这些数据被组合成一个单一的连续测量值。实验室就诊期间的皮质醇浓度与全年的应激暴露相互作用，以至于在第 1 次就诊时皮质醇平均值较低且 12 个月内应激增加的儿童表现出内化症状水平升高。基于这些和相关数据，我们提出在青春期之前，皮质醇降低可能是适应负荷的一个重要标志物，尤其是与抑郁和焦虑的风险相关。
