School of Psychology.
Department of Psychology.
J Abnorm Psychol. 2020 Jan;129(1):92-107. doi: 10.1037/abn0000482. Epub 2019 Oct 28.
Suicide is a leading cause of mortality worldwide. Dysregulated hypothalamic-pituitary-adrenal (HPA) axis activity, as measured by cortisol levels, has been identified as 1 potential risk factor. Evidence has indicated that childhood trauma is associated with dysregulated cortisol reactivity to stress in adulthood. The current study investigated for the first time whether childhood trauma and daily stressors and emotions were associated with diurnal cortisol levels over a 7-day study in individuals vulnerable to suicide. One hundred and forty-two participants were categorized according to their suicidal history into 3 groups: suicide attempt, suicidal ideation, or control group. Participants completed questionnaires before commencing a 7-day study. Cortisol samples were provided immediately upon waking, at 15 min, 30 min, 45 min, 3 hr, 6 hr, 9 hr, and 12 hr on 7 consecutive days. Measures of daily stressors, mood, defeat, and entrapment were completed at the end of each day. Participants in the suicide attempt and ideation groups released significantly lower cortisol upon awakening (CAR) and had a tendency toward flatter wake-peak to 12 hr (WP-12) cortisol slopes compared to controls. Childhood trauma was found to be associated with significantly lower CAR and a tendency toward flatter WP-12 cortisol slope. Childhood trauma also had an indirect effect on suicide vulnerability group membership via lower daily CAR levels. Lower CAR was associated with increased suicide ideation at 1 month but not 6 months. Daily stress and emotion measures were not associated with cortisol levels. This is the first 7-day daily diary investigation of naturally fluctuating cortisol levels in individuals vulnerable to suicide. The results indicate that dysregulated HPA axis activity is associated with suicidal ideation and behavior. Childhood trauma appears to be an important distal factor associated with HPA-axis dysregulation. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
自杀是全球范围内主要的死亡原因之一。研究发现，下丘脑-垂体-肾上腺（HPA）轴活性失调（通过皮质醇水平衡量）是一个潜在的危险因素。有证据表明，童年创伤与成年后应激时皮质醇反应失调有关。本研究首次调查了童年创伤以及日常压力源和情绪是否与易发生自杀的个体在为期 7 天的研究中皮质醇的昼夜节律水平有关。142 名参与者根据自杀史分为 3 组：自杀未遂组、自杀意念组或对照组。参与者在开始为期 7 天的研究前完成了问卷调查。在连续 7 天的每天早上醒来、15 分钟、30 分钟、45 分钟、3 小时、6 小时、9 小时和 12 小时时，提供皮质醇样本。在每天结束时，还完成了日常压力源、情绪、挫败感和束缚感的测量。与对照组相比，自杀未遂组和自杀意念组的个体在醒来时（CAR）释放的皮质醇明显较低，且醒来至 12 小时（WP-12）的皮质醇斜率趋于平坦。童年创伤与 CAR 明显降低且 WP-12 皮质醇斜率趋于平坦有关。童年创伤还通过降低每日 CAR 水平对自杀易感性群体的成员身份产生间接影响。CAR 降低与 1 个月时自杀意念增加有关，但与 6 个月时无关。日常压力和情绪测量与皮质醇水平无关。这是对易发生自杀的个体进行的首次自然波动皮质醇水平的 7 天日常日记研究。结果表明，HPA 轴活性失调与自杀意念和行为有关。童年创伤似乎是与 HPA 轴失调相关的一个重要的远端因素。（PsycINFO 数据库记录（c）2019 APA，保留所有权利）。
