Behavioral Immunology and Endocrinology Laboratory, University of Colorado Denver Anschutz Medical Campus, RC-2, Room 3410A; Mailstop: C268-09, 12700 E. 19th Ave, Aurora, CO 80045, United States.
American Society for the Prevention of Cruelty to Animals (ASPCA), 424 E. 92nd St, New York, NY 10128-6804, United States.
J Psychosom Res. 2015 Nov;79(5):412-9. doi: 10.1016/j.jpsychores.2015.09.012. Epub 2015 Sep 28.
The stress hormone cortisol exhibits a diurnal rhythm throughout the day, as well as within person variability. Recent statistical approaches allow for the estimation of intraindividual cortisol variability ("ICV") and a greater ICV has been observed in some mood disorders (major depression, remitted bipolar disorder); however, ICV has not been examined following stress management. In this secondary analyses of an efficacious randomized clinical trial, we examine how ICV may change after cognitive behavioral stress management (CBSM) among healthy stressed women at risk for breast cancer. Second, we concurrently compare other calculations of cortisol that may change following CBSM.
Multilevel modeling (MLM) was applied to estimate ICV and to test for a group by time interaction from baseline, post-intervention, to 1 month following CBSM. Forty-four women were randomized to the CBSM; 47 to the comparison group; mean age of the entire group was 44.2 (SD=10.27).
After controlling for relevant covariates, a significant time by group interaction emerged (β estimate=-.070; p<.05), such that CBSM participants demonstrated a lower ICV following CBSM compared to the comparison group. The interaction for cortisol slope and cortisol output (area under the curve) approached significance (β estimates=-.10 and -.062, respectively; p's<.08), while other cortisol outcomes tested were not significantly changed following CBSM.
ICV may represent a novel index of cortisol dysregulation that is impacted by CBSM and may represent a more malleable within-person calculation than other, widely applied cortisol outcomes. Future research should examine these relationships in larger samples, and examine ICV and health outcomes.
NCT01048528.
应激激素皮质醇在一天中表现出昼夜节律，并且个体内也存在可变性。最近的统计方法允许估计个体内皮质醇变异性（“ICV”），并且在一些心境障碍（重度抑郁症，缓解期双相情感障碍）中观察到更大的 ICV；但是，应激管理后尚未检查 ICV。在一项有效的随机临床试验的二次分析中，我们研究了在有乳腺癌风险的健康压力女性中，认知行为应激管理（CBSM）后 ICV 是否会发生变化。其次，我们同时比较了 CBSM 后可能发生变化的其他皮质醇计算方法。
多级模型（MLM）用于估计 ICV，并从基线，干预后到 CBSM 后 1 个月测试组与时间的交互作用。44 名妇女被随机分配到 CBSM；47 名妇女被分配到对照组；整个组的平均年龄为 44.2（SD=10.27）。
在控制了相关协变量后，出现了显著的时间与组之间的交互作用（β估计值=-.070；p<.05），表明与对照组相比，CBSM 参与者在接受 CBSM 后 ICV 较低。皮质醇斜率和皮质醇输出（曲线下面积）的交互作用接近显著（β估计值分别为-.10 和-.062；p's<.08），而其他测试的皮质醇结果在接受 CBSM 后没有明显变化。
ICV 可能代表皮质醇失调的新指标，受 CBSM 影响，并且可能代表比其他广泛应用的皮质醇结果更具可塑性的个体内计算方法。未来的研究应在更大的样本中检查这些关系，并检查 ICV 和健康结果。
NCT01048528。
