Prolonged psychological stress suppresses cortisol secretion

Abstract

Prolonged psychological stress is associated with a transient suppression of the HPA axis, manifested by low morning cortisol and reduced cortisol response to ACTH. The reduction of cortisol response is sufficient to cause false diagnosis of HPA insufficiency.

Associations between HPA axis functioning and level of anxiety in children and adolescents with an anxiety disorder

“…The negative association between scores on the MASC Harm Avoidance scale and cortisol concentrations immediately after awakening was in accordance with earlier findings of lower early morning cortisol concentrations in children with an anxiety disorder [Feder et al, 2004] and with studies that found a negative association between early morning cortisol concentrations and chronic stress in adults [Preussner et al, 1999;Zarkovic et al, 2003]. According to Feder et al [2004], lower cortisol concentrations during the night and early morning in children with an anxiety disorder may be associated with disturbances in sleep dynamics.…”

“…Some authors hypothesized that increases in cortisol concentrations due to regular, or occasional but severe, stress may cause down-regulation of the HPA axis [De Kloet, 2003;Sapolsky et al, 2000], which is in accordance with findings in animals [McEwen, 2001;Spencer et al, 1996] Down-regulation of basal HPA axis-activity can be reflected in changes in rise of cortisol concentrations after awakening [cortisol awakening rise (CAR): Grossi et al, 1998;Ockenfels et al, 1995;Preussner et al, 1997Preussner et al, , 2003aVingerhoets et al, 1996;Wü st et al, 2000a;Zarkovic et al, 2003], the area under the curve (AUC), which is constructed by using multiple cortisol assessments over the day [Preussner et al, 2003b;Rosmalen et al, 2005], or cortisol concentrations on specific moments of the day, for example immediately after awakening or late in the evening [Rosmalen et al, 2005;Yehuda et al, 2005a].…”

Exhaustion measured by the SF-36 vitality scale is associated with a flattened diurnal cortisol profile

“…Exhaustion may as such be explored in terms of an outcome of chronic stress, as well as a potential intermediate link between stressor exposure and manifest disease. Previous stress research has to a large extent used measures of depressive symptomatology and anxiety in order to assess immediate or intervening health effects of chronic stress (Cohen et al, 1995;Zarkovic et al, 2003). Hypothetically, individuals may be prone to different reaction patterns in chronic stress (behaviourally and physiologically), and exhaustion might constitute one such type of response.…”

“…In a study of medically healthy individuals it was shown that cortisol levels that were substantially suppressed due to severe chronic stress returned to normal after termination of the stressful period (Zarkovic et al, 2003). Chronic stress thus seems to exert a "direct" effect on the HPA axis in reducing its activity, i. e. without being mediated by disease.…”

Psychobiology of persistent antisocial behavior: Stress, early vulnerabilities and the attenuation hypothesis

“…Importantly, transformations can lead to desistence from antisocial behavior. In addition, prolonged CRH endocrine system arousal related to chronic stressor exposure can transform hyperarousal in acute stressful situations to the hypoarousal state described above (Zarkovic et al, 2003).…”