Leggett Amanda N, Zarit Steven H, Kim Kyungmin, Almeida David M, Klein Laura Cousino
Department of Psychiatry, The University of Michigan, Ann Arbor.
Department of Human Development and Family Studies, The Pennsylvania State University, University Park.
J Gerontol B Psychol Sci Soc Sci. 2015 Nov;70(6):820-9. doi: 10.1093/geronb/gbu070. Epub 2014 Jun 12.
This study examines the association of daily cortisol with depressive mood and anger.
Depressive mood, anger and 2 markers of cortisol, area under the curve (AUC), and cortisol awakening response (CAR) were examined for caregivers (N = 164) of individuals with dementia (IWDs) across 8 days, some of which IWDs attended an adult day service (ADS) program. Caregivers were primarily female (86.7%) with a mean age of 61.99. First, multilevel models were run with CAR and AUC each as separate covariates of anger and depressive mood. A second set of models examined contextual factors of caregivers (i.e., care-related stressors and amount of ADS use) were added to the models for anger and depressive mood (Model 2).
On days where caregivers had AUCs below their average they expressed higher anger scores. However in Model 2, anger was associated with more care-related stressors, but not ADS use or daily cortisol. Caregivers who on average had smaller CARs were more likely to be depressed. In Model 2, depressed mood was associated with more care-related stressors and a low average CAR.
We found that hypocortisol patterns, reflective of chronic stress experienced by caregivers, are associated with negative mood.
本研究探讨每日皮质醇与抑郁情绪及愤怒之间的关联。
对164名痴呆症患者（IWDs）的照料者进行了为期8天的抑郁情绪、愤怒以及皮质醇的两个指标，即曲线下面积（AUC）和皮质醇觉醒反应（CAR）的检测，其中部分IWDs参加了成人日间服务（ADS）项目。照料者主要为女性（86.7%），平均年龄为61.99岁。首先，分别以CAR和AUC作为愤怒和抑郁情绪的单独协变量运行多层次模型。第二组模型将照料者的背景因素（即与照料相关的压力源和ADS使用量）添加到愤怒和抑郁情绪模型中（模型2）。
在照料者的AUC低于其平均水平的日子里，他们的愤怒得分更高。然而在模型2中，愤怒与更多与照料相关的压力源相关，但与ADS使用或每日皮质醇无关。平均CAR较小的照料者更有可能出现抑郁情绪。在模型2中，抑郁情绪与更多与照料相关的压力源以及较低的平均CAR相关。
我们发现，反映照料者经历的慢性压力的低皮质醇模式与负面情绪相关。
