Levi Eyal, Fischer Susanne, Fisher Hadar, Admon Roee, Zilcha-Mano Sigal
School of Psychological Sciences, University of Haifa, Mount Carmel, Haifa 31905, Israel.
Institute of Psychology, Clinical Psychology and Psychotherapy, University of Zurich, 8050 Zürich, Switzerland.
Brain Sci. 2021 Nov 10;11(11):1483. doi: 10.3390/brainsci11111483.
The importance of the role of affect in psychotherapy for major depressive disorder (MDD) is well established, but the common use of self-reported measures may limit our understanding of its underlying mechanisms. A promising predictor of patient affect is the stress hormone cortisol. To date, no studies have studied in-session changes in cortisol in psychotherapy for MDD. We investigated whether an increase in patient cortisol over the course of a session correlated with higher negative and lower positive affect. Given previous findings on healthy individuals on the contagious nature of stress, an additional aim was to examine whether these relationships are moderated by therapist cortisol. To this end, 40 dyads (including 6 therapists) provided saliva samples before and after four pre-specified sessions (616 samples). After each session, the patients provided retrospective reports of in-session affect. We found no association between patient cortisol and affect. However, increases in patient cortisol predicted negative affect when the therapists exhibited decreases in cortisol, and increases in patient cortisol predicted positive affect when the therapists showed increases. Our study provides initial evidence for the importance of the social context in the cortisol-affect relationship in MDD.
情感在重度抑郁症（MDD）心理治疗中的作用已得到充分证实，但其潜在机制仍不清楚，因为目前常用的是自我报告法。应激激素皮质醇是患者情感的一个有前景的预测指标。迄今为止，尚无研究探讨MDD心理治疗过程中皮质醇的变化。我们研究了患者在治疗过程中皮质醇的增加是否与更高的消极情感和更低的积极情感相关。鉴于先前关于健康个体应激传染性的研究结果，另一个目的是检验这些关系是否受治疗师皮质醇的调节。为此，40对（包括6名治疗师）在四个预先指定的疗程前后提供了唾液样本（共616个样本）。每个疗程后，患者提供疗程中情感的回顾性报告。我们发现患者皮质醇与情感之间没有关联。然而，当治疗师的皮质醇水平下降时，患者皮质醇的增加预示着消极情感，而当治疗师的皮质醇水平上升时，患者皮质醇的增加预示着积极情感。我们的研究为社会环境在MDD皮质醇-情感关系中的重要性提供了初步证据。
