Research Group Longitudinal and Intervention Research, Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, University of Heidelberg, Medical Faculty Mannheim, Mannheim, Germany.
Department of Biostatistics, Central Institute of Mental Health, University of Heidelberg, Medical Faculty Mannheim, Mannheim, Germany.
Psychoneuroendocrinology. 2023 Sep;155:106307. doi: 10.1016/j.psyneuen.2023.106307. Epub 2023 May 25.
Habitual modes of thinking such as repetitive negative thinking (RNT), but also momentary cognitive processes such as mindwandering could be vulnerability factors for the course of Major Depressive Disorder (MDD). On the physiological level, cortisol represents an important biological stress marker of the hypothalamic-pituitary-adrenal (HPA) axis. Being a dynamic and non-invasive measure, salivary cortisol can be assessed in daily life via Ambulatory Assessment (AA). So far, consensus exists on a dysregulation of the HPA axis in MDD. However, findings are ambiguous and AA-studies examining both trait and state level effects of cognitive processes on cortisol release in daily life in patients with recurrent major depression (rMDD) and healthy controls (HCs) are lacking. A sample of 119 (n=57, n=62) participants underwent a baseline session, including self-rated questionnaires (RNT, mindfulness) followed by a 5-day AA, where participants indicated the occurrence of mindwandering and levels of mentalshift problems ten times per day via smartphone, and collected saliva cortisol samples five times per day. Via multilevel models, we found habitual RNT, but not mindfulness, to predict higher cortisol levels, with the effects being stronger in rMDD patients. State mindwandering and mentalshift problems predicted increased cortisol 20 min later across groups. State cognitions did not mediate the effects of habitual RNT on cortisol release. Our results suggest independent mechanisms of action for trait and state cognitions on cortisol activity in daily life and indicate a greater physiological vulnerability toward trait RNT and the tendency to experience mentalshift problems in patients with recurrent major depression.
习惯性思维模式，如重复性消极思维（RNT），以及瞬间的认知过程，如思维漫游，都可能是重度抑郁症（MDD）病程的脆弱因素。在生理水平上，皮质醇是下丘脑-垂体-肾上腺（HPA）轴的一个重要生物应激标志物。作为一种动态且非侵入性的测量方法，唾液皮质醇可以通过动态评估（AA）在日常生活中进行评估。到目前为止，人们对 MDD 中 HPA 轴的失调已经达成共识。然而，研究结果并不一致，并且缺乏 AA 研究来检验认知过程在复发性重度抑郁症（rMDD）患者和健康对照者（HCs）的日常生活中对皮质醇释放的特质和状态水平的影响。一项由 119 名参与者（n=57，n=62）组成的样本接受了基线评估，包括自我报告的问卷（RNT、正念），随后进行了为期 5 天的 AA，参与者通过智能手机每天 10 次报告思维漫游的发生情况和心理转变问题的程度，并每天采集 5 次唾液皮质醇样本。通过多层模型，我们发现习惯性 RNT，而不是正念，预测更高的皮质醇水平，rMDD 患者的影响更强。状态思维漫游和心理转变问题预测了两组参与者皮质醇水平在 20 分钟后增加。状态认知并不能调节习惯性 RNT 对皮质醇释放的影响。我们的研究结果表明，特质和状态认知对日常生活中皮质醇活动有独立的作用机制，并表明在复发性重度抑郁症患者中，特质 RNT 具有更大的生理脆弱性，以及经历心理转变问题的倾向。
