Cortisol and alpha-amylase assessment in psychotherapeutic intervention studies: A systematic review

Laufer, Sebastian; Engel, Sinha; Knaevelsrud, Christine; Schumacher, Sarah

doi:10.1016/j.neubiorev.2018.09.023

Cited by 28 publications

(19 citation statements)

References 75 publications

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“…Second, there is no data on the long-term trajectory of cortisol after patients have undergone TF-CBT. Collecting such data could be important since a number of studies in depression and anxiety disorders have reported significant changes in cortisol at follow-up rather than at the end of treatment (Fischer and Zilcha-Mano under review; Laufer et al 2018 ), indicating that therapeutic changes in biological systems may emerge with a time delay. Supporting this notion, a recent study in patients with anxiety disorders provided initial evidence that pre- to post-treatment changes in FKBP5 methylation were strongly associated with treatment outcome at six-month follow-up but not at post-treatment (Roberts et al 2019 ).…”

Section: Discussionmentioning

confidence: 99%

Genes and hormones of the hypothalamic–pituitary–adrenal axis in post-traumatic stress disorder. What is their role in symptom expression and treatment response?

et al. 2021

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Background Less than half of all individuals with post-traumatic stress disorder (PTSD) remit spontaneously and a large proportion of those seeking treatment do not respond sufficiently. This suggests that there may be subgroups of individuals who are in need of augmentative or alternative treatments. One of the most frequent pathophysiological findings in PTSD is alterations in the hypothalamic–pituitary–adrenal (HPA) axis, including enhanced negative feedback sensitivity and attenuated peripheral cortisol. Given the role of the HPA axis in cognition, this pattern may contribute to PTSD symptoms and interfere with key processes of standard first-line treatments, such as trauma-focused cognitive behavioural therapy (TF-CBT). Methods This review provides a comprehensive summary of the current state of research regarding the role of HPA axis functioning in PTSD symptoms and treatment. Results Overall, there is preliminary evidence that hypocortisolaemia contributes to symptom manifestation in PTSD; that it predicts non-responses to TF-CBT; and that it is subject to change in parallel with positive treatment trajectories. Moreover, there is evidence that genetic and epigenetic alterations within the genes NR3C1 and FKBP5 are associated with this hypocortisolaemic pattern and that some of these alterations change as symptoms improve over the course of treatment. Conclusions Future research priorities include investigations into the role of the HPA axis in day-to-day symptom variation, the time scale in which biological changes in response to treatment occur, and the effects of sex. Furthermore, before conceiving augmentative or alternative treatments that target the described mechanisms, multilevel studies are warranted.

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Section: Discussionmentioning

confidence: 99%

Genes and hormones of the hypothalamic–pituitary–adrenal axis in post-traumatic stress disorder. What is their role in symptom expression and treatment response?

et al. 2021

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“…Because alterations of the HPA axis and the ANS appear to be involved in the development and maintenance of depression, it is conceivable that these dysregulations may interact with psychotherapeutic treatment to influence outcomes. A meta-analysis that attempted to investigate the effect of psychotherapy on HPA and ANS regulation in adults with mixed mental health disorders concluded that this effect could not be estimated due to the large degree of heterogeneity of methodologies across studies 291 .…”

Section: Resilience-enhancing Interventionsmentioning

confidence: 99%

Psychobiological factors of resilience and depression in late life

Laird¹,

Krause²,

Funes³

et al. 2019

Transl Psychiatry

165

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In contrast to traditional perspectives of resilience as a stable, trait-like characteristic, resilience is now recognized as a multidimentional, dynamic capacity influenced by life-long interactions between internal and environmental resources. We review psychosocial and neurobiological factors associated with resilience to late-life depression (LLD). Recent research has identified both psychosocial characteristics associated with elevated LLD risk (e.g., insecure attachment, neuroticism) and psychosocial processes that may be useful intervention targets (e.g., self-efficacy, sense of purpose, coping behaviors, social support). Psychobiological factors include a variety of endocrine, genetic, inflammatory, metabolic, neural, and cardiovascular processes that bidirectionally interact to affect risk for LLD onset and course of illness. Several resilience-enhancing intervention modalities show promise for the prevention and treatment of LLD, including cognitive/psychological or mind–body (positive psychology; psychotherapy; heart rate variability biofeedback; meditation), movement-based (aerobic exercise; yoga; tai chi), and biological approaches (pharmacotherapy, electroconvulsive therapy). Additional research is needed to further elucidate psychosocial and biological factors that affect risk and course of LLD. In addition, research to identify psychobiological factors predicting differential treatment response to various interventions will be essential to the development of more individualized and effective approaches to the prevention and treatment of LLD.

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“…Epinephrine influences cardiovascular activity, leading to an increase in heart rate (HR), blood pressure (BP) as well as metabolic changes, such as an increase in the oxidative stress [3]. Activation of SAM also results in the secretion of salivary alpha-amylase, which appears to be a good candidate for a biochemical marker of SAM activation [4,5].…”

Section: Introductionmentioning

confidence: 99%

Female Volleyball Players Are More Prone to Cortisol Anticipatory Stress Response than Sedentary Women

et al. 2019

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Background and Objectives: Top-level sports performance places heavy physical and psychological demands on elite-level athletes, which can be a source of increased levels of stress. Therefore, high-level volleyball players may present altered cardiovascular and endocrinological stress response during stressful events. Although many previous studies have examined the response to stress on athletes, most of them regarded only males, while the impact of the female menstrual cycle has rarely been taken into account. We aimed to study psychophysiological response to anticipatory stressor through analysis of heart rate, self-reported anxiety level, and salivary cortisol in healthy young female athletes by minimalizing the effect of confounders. Materials and Methods: A total of 55 females (25 members of the best league for female volleyball players in Poland and 30 sedentary-lifestyle control subjects) in the follicular phase of their menstrual cycle were exposed to mental arithmetic tasks as an experimental imitation of the stressor. Volleyball players were significantly taller than sedentary individuals (177.1 ± 3.4 cm vs. 173.3 ± 3.4 cm, respectively, p = 0.034), but did not differ in weight (73.6 ± 5.2 kg vs. 70 ± 4.23 kg, respectively, p = 0.081), body mass index (BMI) (23.5 ± 1.13 vs. 24.1 ± 1.45, respectively, p = 0.060), and age (22 ± 1.11 vs. 23 ± 1.14 years, respectively, p = 0.2). Their stress responses were assessed through self-reported anxiety levels and physiological measurements of salivary cortisol concentrations and heart rate (HR). Results: For HR, significant effects of time (F(2,120) = 21.34, p < 0.001, η2 = 0.26) were found, but not for training status (F(1,60) = 2.69, p = 0.106, η2 = 0.04). For cortisol levels, the analysis showed the main effects of time (F(3,180) = 11.73, p < 0.001, η2 = 0.16) and training status (F(1,60) = 4.69, p = 0.034, η2 = 0.07) and a significant interaction between training status and time (F(3,180) = 3.07, p = 0.029, η2 = 0.05). Post-hoc analyses showed higher cortisol concentrations among volleyball players following the math task (all p < 0.001), as well as higher cortisol concentrations in S2, S3, and S4 compared to S1 in volleyball players (all p < 0.001). We observed also a significant increase in state anxiety in both groups (all p < 0.001), but no differences in state anxiety levels between groups. Conclusion: Female volleyball players may not differ in subjective graduation of stressors; however, exposure to training-based stressors seems to promote cortisol response to the anticipated stressor.

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Cortisol and alpha-amylase assessment in psychotherapeutic intervention studies: A systematic review

Cited by 28 publications

References 75 publications

Genes and hormones of the hypothalamic–pituitary–adrenal axis in post-traumatic stress disorder. What is their role in symptom expression and treatment response?

Genes and hormones of the hypothalamic–pituitary–adrenal axis in post-traumatic stress disorder. What is their role in symptom expression and treatment response?

Psychobiological factors of resilience and depression in late life

Female Volleyball Players Are More Prone to Cortisol Anticipatory Stress Response than Sedentary Women

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