Hair cortisol and childhood trauma predict psychological therapy response in depression and anxiety disorders

Fischer, Susanne; King, Sinéad; Papadopoulos, Andrew; Hotopf, Matthew; Young, Allan H.; Cleare, Anthony J.

doi:10.1111/acps.12970

Cited by 25 publications

(25 citation statements)

References 48 publications

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“…The current null findings with regard to the cortisol and cortisone awakening response are in line with meta-analytical data suggesting no effect of salivary cortisol as a predictor for treatment response ( Fischer and Cleare, 2017 ). Despite the advantage of hair steroid analysis as an index of long-term integrated GCs, no predictive relationship was revealed, which is in contrast to one previous study on outpatients suffering from depression and anxiety disorders (e.g., PTSD, panic disorder, agoraphobia; Fischer et al, 2018 ). Again, the fact that the current study mainly focused on healthy spider-fearful individuals might have resulted in reduced variance in baseline long-term GC levels impeding the detection of meaningful relationships.…”

Section: Discussioncontrasting

confidence: 99%

“…An important advancement in this respect is hair steroid analysis, which represents a marker of long-term GC secretion integrated over periods of several months (Stalder et al, 2017). In fact, a recent study in this context observed higher hair cortisol concentrations as a predictor of improved therapy response in depression and anxiety disorder patients (Fischer et al, 2018). Hence, hair GC analysis may effectively complement research into endocrine predictors of clinical symptom change in response to exposure therapy.…”

Section: Introductionmentioning

confidence: 99%

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Hydrocortisone as an adjunct to brief cognitive-behavioural therapy for specific fear: Endocrine and cognitive biomarkers as predictors of symptom improvement

et al. 2021

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Background: Glucocorticoid (GC) administration prior to exposure-based cognitive-behavioural therapy (CBT) has emerged as a promising approach to facilitate treatment outcome in anxiety disorders. Further components relevant for improved CBT efficacy include raised endogenous GCs and reductions in information-processing biases to threat. Aims: To investigate hydrocortisone as an adjunct to CBT for spider fear and the modulating role of threat bias change and endogenous short-term and long-term GCs for treatment response. Methods: Spider-fearful individuals were randomized to receiving either 20 mg of hydrocortisone ( n = 17) or placebo ( n = 16) one hour prior to single-session predominantly computerised exposure-based CBT. Spider fear was assessed using self-report and behavioural approach measures at baseline, 1-day and 1-month follow-up. Threat processing was assessed at baseline and 1-day follow-up. Cortisol and cortisone were analysed from hair and saliva samples at baseline. Results/outcomes: Self-report, behavioural and threat processing indices improved following CBT. Hydrocortisone augmentation resulted in greater improvement of self-report spider fear and stronger increase in speed when approaching a spider, but not on threat bias. Neither threat bias nor endogenous GCs predicted symptom change, and no interactive effects with hydrocortisone emerged. Preliminary evidence indicated higher hair cortisone as predictor of a stronger threat bias reduction. Conclusions/interpretation: Our data extend earlier findings by suggesting that GC administration boosts the success of exposure therapy for specific fear even with a low-level therapist involvement. Future studies corroborating our result of a predictive hair GC relationship with threat bias change in larger clinical samples are needed.

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Section: Discussioncontrasting

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Hydrocortisone as an adjunct to brief cognitive-behavioural therapy for specific fear: Endocrine and cognitive biomarkers as predictors of symptom improvement

et al. 2021

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“…To measure the psychopathology of depressive mood (using the patient health questionnaire-9 (PHQ-9)) 47–49 , anxiety (by applying the generalised anxiety disorder 7-item (GAD-7)) 50–52 , substance abuse (alcohol; using the CAGE questionnaire) 53–55 , cognitive style of daily living (by applying the adult attention-deficit/hyperactivity disorder (ADHD) self-report scale (ASRS-v.1.1)) 44–46 , as well as social interaction patterns [of non-confrontational coping, including the anxiety-fear-avoidance for social situation 56–59 (the Liebowitz social anxiety scale (LSAS)) and preference for non-face-to-face social interaction combined with smartphone overuse 60–62 (the smartphone addiction scale (SAS))], that have been associated with perceived verbal abuse (by applying the verbal abuse questionnaire (VAQ)), we applied several self-reporting questionnaire listed below.…”

Section: Methodsmentioning

confidence: 99%

Verbal Abuse Related to Self-Esteem Damage and Unjust Blame Harms Mental Health and Social Interaction in College Population

Yun

Shim

Jeong

2019

Sci Rep

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Verbal abuse is an emotional abuse intended to inflict intense humiliation-denigration-fear as perceived by exposed person. Network-based approaches have been applied to explore the integrativesegregated patterns of associations among the psychological features and external stimuli for diverse populations; few studies reported for verbal abuse effects in college population. Self-reporting measurements acquired form 5,616 college students were used for network analyses. Escalating cascades of verbal abuse from differential sources (parents, peers, or supervisors; network 1) and directed associations among verbal abuse severity-psychopathology-social interaction (network 2) were estimated using the directed acyclic graphs. principal connectors of verbal abuse-psychopathologysocial interaction were shown using the graph theory metrics calculated from the intra-individual covariance networks (network 3). Directed propagating patterns of verbal abuse phenomena differed by source (network 1). Severe peer-related verbal abuse affected psychomotor changes and influenced irritability (network 2). Verbal abuse of self-esteem damage and unjust blame served as connectors in the verbal abuse-psychopathology-social interaction; influence of smartphone overuse-related distress was stronger in cases with more severe verbal abuse (network 3). Verbal abuse that damages selfesteem and conveys unjust blame harms mental health and social interaction for college population. Verbal abuse is a form of emotional abuse intended to inflict intense humiliation, denigration, or extreme fear, as perceived by the victimised person 1. Perceived parental verbal abuse in childhood and peer-related verbal abuse in adolescence have been associated with a risk of depressive mood, anxiety, anger-hostility, suicidality, dissociation, or drug use in young adulthood 2-6. Moreover, experience of perceived verbal abuse has been associated with changed patterns of brain maturation, including the reduced structural integrity of brain white matter bundles 7 , compromised brain resting state functional connectivity 8,9 , and decreased brain grey matter volumes in regions responsible for sensory processing, emotional regulation, and social interaction-related cognitive functioning such as language and memory. All of the above factors have been suggested to reflect the neural underpinning of the psychopathology 10-16. Further, perceived verbal abuse in adulthood in relation to intimate partner violence and workplace mistreatment also affects brain morphology and undermines mental health 17,18. However, unlike the extreme clinical syndromes developing after trauma, such as post-traumatic stress disorder 19,20 , few studies have explored interactions among perceived, verbal abuse-psychopathology-social interaction patterns in young adult populations. Using network-based approaches, integrative as well as segregated patterns of interactions among the psychopathology, cognitive functioning, and perceived external stimuli have been explored in various populations 19...

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“…This interaction could be key for understanding the etiological mechanisms involved in such conditions, as well as for identifying potential therapeutic mechanisms. [20][21][22][23][24][25][26] In addition, hair cortisol reflecting long-term HPA activity has recently emerged as a potential predictor of treatment response in anxiety and depression. 19 The therapeutic options available for chronic pain management are very extensive.…”

Section: Introductionmentioning

confidence: 99%

Efficacy, cost-utility and physiological effects of Acceptance and Commitment Therapy (ACT) and Behavioural Activation Treatment for Depression (BATD) in patients with chronic low back pain and depression: study protocol of a randomised, controlled trial including mobile-technology-based ecological momentary assessment (IMPACT study)

et al. 2020

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IntroductionThe IMPACT study focuses on chronic low back pain (CLBP) and depression symptoms, a prevalent and complex problem that represents a challenge for health professionals. Acceptance and Commitment Therapy (ACT) and Brief Behavioural Activation Treatment for Depression (BATD) are effective treatments for patients with persistent pain and depression, respectively. The objectives of this 12 month, multicentre, randomised, controlled trial (RCT) are (i) to examine the efficacy and cost-utility of adding a group-based form of ACT or BATD to treatment-as-usual (TAU) for patients with CLBP and moderate to severe levels of depressive symptoms; (ii) identify pre–post differences in levels of some physiological variables and (iii) analyse the role of polymorphisms in the FKBP5 gene, psychological process measures and physiological variables as mediators or moderators of long-term clinical changes.Methods and analysisParticipants will be 225 patients with CLBP and moderate to severe depression symptoms recruited at Parc Sanitari Sant Joan de Déu (St. Boi de Llobregat, Spain) and Hospital del Mar (Barcelona, Spain), randomly allocated to one of the three study arms: TAU vs TAU+ACT versus TAU+BATD. A comprehensive assessment to collect clinical variables and costs will be conducted pretreatment, post-treatment and at 12 months follow-up, being pain interference the primary outcome measure. The following physiological variables will be considered at pretreatment and post-treatment assessments in 50% of the sample: immune-inflammatory markers, hair cortisol and cortisone, serum cortisol, corticosteroid-binding globulin and vitamin D. Polymorphisms in the FKBP5 gene (rs3800373, rs9296158, rs1360780, rs9470080 and rs4713916) will be analysed at baseline assessment. Moreover, we will include mobile-technology-based ecological momentary assessment, through the Pain Monitor app, to track ongoing clinical status during ACT and BATD treatments. Linear mixed-effects models using restricted maximum likelihood, and a full economic evaluation applying bootstrapping techniques, acceptability curves and sensitivity analyses will be computed.Ethics and disseminationThis study has been approved by the Ethics Committee of the Fundació Sant Joan de Déu and Hospital del Mar. The results will be actively disseminated through peer-reviewed journals, conference presentations, social media and various community engagement activities.Trial registration numberNCT04140838

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Hair cortisol and childhood trauma predict psychological therapy response in depression and anxiety disorders

Cited by 25 publications

References 48 publications

Hydrocortisone as an adjunct to brief cognitive-behavioural therapy for specific fear: Endocrine and cognitive biomarkers as predictors of symptom improvement

Hydrocortisone as an adjunct to brief cognitive-behavioural therapy for specific fear: Endocrine and cognitive biomarkers as predictors of symptom improvement

Verbal Abuse Related to Self-Esteem Damage and Unjust Blame Harms Mental Health and Social Interaction in College Population

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