Department of Psychology, Williams College, Williamstown, MA, 01267, USA.
Department of Psychology, University of North Carolina at Greensboro, Greensboro, NC 27402-6170, USA.
Psychoneuroendocrinology. 2019 Sep;107:9-18. doi: 10.1016/j.psyneuen.2019.04.017. Epub 2019 Apr 27.
The cortisol awakening response (CAR) has been shown to prospectively predict depression, but it remains unresolved whether a greater CAR predicts risk independently of subsequent acute stress, or whether greater CAR indicates increased vulnerability to subsequent acute stress. Further, no prior work has evaluated whether the CAR increases vulnerability to certain types of acute stress, but not others, in predicting depression. To address these gaps, we investigated whether the CAR predicted depressive symptoms alone and in interaction with acute interpersonal stress in a one-year longitudinal study of 86 early adolescent girls with no history of diagnosable depression. To index the CAR, adolescents collected saliva at waking and 30-minutes past waking for 3 days; compliance with the sampling protocol was electronically monitored. Diagnostic and objective contextual stress interviews were used to quantify acute stress in the 2-months prior to worst depressive symptom onset during the follow-up. Supporting hypotheses, results indicated that greater CAR predicted greater depressive symptoms, and interacted with acute interpersonal stress in predicting depressive symptoms. Further, the CAR interacted with acute dependent (i.e., at least partially arising from the person's behavior) interpersonal stress in predicting depressive symptoms. In contrast, the CAR did not interact with acute non-interpersonal stress nor acute interpersonal independent (i.e., fateful) stress in predicting depressive symptoms. These results further refine circumstances in which the CAR is predictive of depressive symptoms among early adolescent girls, and highlight the importance of focusing on etiologically relevant stress when testing interactions between physiological stress indicators and environmental stress.
皮质醇觉醒反应（CAR）已被证明可以前瞻性地预测抑郁，但仍不清楚更大的 CAR 是否可以独立于随后的急性应激预测风险，或者更大的 CAR 是否表明对随后的急性应激更敏感。此外，以前没有研究评估 CAR 是否会增加对某些类型的急性应激的敏感性，而不会增加对其他类型的急性应激的敏感性，从而预测抑郁。为了解决这些差距，我们在一项为期一年的纵向研究中，调查了 86 名早期青春期女孩的皮质醇觉醒反应（CAR）是否单独预测抑郁症状，以及是否与急性人际应激相互作用，这些女孩以前没有诊断为抑郁症。为了评估 CAR，青少年在三天内每天醒来和醒来后 30 分钟采集唾液；电子监测采样方案的依从性。使用诊断性和客观的情境压力访谈来量化在随访期间出现最严重抑郁症状之前的 2 个月内的急性应激。支持假设的结果表明，更大的 CAR 预测更大的抑郁症状，并且与急性人际应激相互作用预测抑郁症状。此外，CAR 与急性依赖型（即至少部分源于他人行为）人际应激相互作用，预测抑郁症状。相比之下，CAR 与急性非人际应激或急性人际独立（即命中注定）应激相互作用，不会预测抑郁症状。这些结果进一步完善了 CAR 在预测早期青春期女孩抑郁症状的情况下的预测条件，并强调了在测试生理应激指标与环境应激之间的相互作用时，关注与病因相关的应激的重要性。
