Department of Psychiatry, University of California, San Diego, San Diego, CA, USA.
Clinical Neuroscience and Psychotherapeutics Research Unit, Department of Psychiatry and Behavioral Health, The Ohio State University Wexner Medical Center, Columbus, OH, USA.
Psychoneuroendocrinology. 2023 May;151:106070. doi: 10.1016/j.psyneuen.2023.106070. Epub 2023 Feb 22.
The role of the hypothalamic-pituitary-adrenal (HPA) axis in human aggressive behavior is poorly characterized, though some studies report that, unlike depression, circulating or salivary levels of cortisol are low compared with controls.
In this study, we collected three salivary cortisol levels (two in the morning and one in the evening) on three separate days in 78 adult study participants with (n = 28) and without (n = 52) prominent histories of impulsive aggressive behavior. Plasma C-Reactive Protein (CRP) and Interleukin-6 (IL-6) were also collected in most study participants. Aggressive study participants meet DSM-5 criteria for Intermittent Explosive Disorder (IED) while non-aggressive participants either had a history of a psychiatric disorder or no such history (Controls).
Morning, but not evening, salivary cortisol levels were significantly lower in IED (p < 0.05), compared with control, study participants. In addition, salivary cortisol levels correlated with measures of trait anger (partial r = -0.26, p < 0.05) and aggression (partial r = -0.25, p < 0.05) but not with measures of impulsivity, psychopathy, depression, history of childhood maltreatment, or other tested variables that often differ in individuals with IED. Finally, plasma CRP levels correlated inversely with morning salivary cortisol levels (partial r = -0.28, p < 0.05); plasma IL-6 levels showed a similar, though not statistically significant (r = -0.20, p = 0.12) relationship with morning salivary cortisol levels.
The cortisol awakening response appears to be lower in individuals with IED compared with controls. In all study participants, morning salivary cortisol levels correlated inversely with trait anger, trait aggression, and plasma CRP, a marker of systemic inflammation. This suggests the present of a complex interaction between chronic-low level inflammation, the HPA axis, and IED that warrants further investigation.
尽管一些研究报告称，与抑郁症不同，皮质醇的循环或唾液水平与对照组相比较低，但下丘脑-垂体-肾上腺（HPA）轴在人类攻击行为中的作用仍未得到充分描述。
在这项研究中，我们在 78 名成年研究参与者中，在三个不同的日子里收集了三个唾液皮质醇水平（两个早晨，一个晚上），其中 28 名有明显冲动性攻击行为史，52 名无明显冲动性攻击行为史。大多数研究参与者还收集了血浆 C 反应蛋白（CRP）和白细胞介素-6（IL-6）。具有间歇性爆发障碍（IED）DSM-5 标准的攻击性行为研究参与者，而无攻击性行为参与者则有或没有精神病史（对照组）。
与对照组相比，IED 组（p<0.05）早晨唾液皮质醇水平显著降低，但晚上唾液皮质醇水平无差异。此外，唾液皮质醇水平与特质愤怒（部分 r=-0.26，p<0.05）和攻击（部分 r=-0.25，p<0.05）呈负相关，但与冲动性、精神病态、抑郁、童年虐待史或其他经测试的变量无关，这些变量在 IED 患者中经常不同。最后，血浆 CRP 水平与早晨唾液皮质醇水平呈负相关（部分 r=-0.28，p<0.05）；血浆 IL-6 水平与早晨唾液皮质醇水平呈相似（尽管无统计学意义 r=-0.20，p=0.12）关系。
与对照组相比，IED 个体的皮质醇觉醒反应似乎较低。在所有研究参与者中，早晨唾液皮质醇水平与特质愤怒、特质攻击和血浆 CRP 呈负相关，血浆 CRP 是全身性炎症的标志物。这表明慢性低水平炎症、HPA 轴和 IED 之间存在复杂的相互作用，需要进一步研究。
