Hostname: page-component-78c5997874-s2hrs Total loading time: 0 Render date: 2024-11-05T07:50:28.907Z Has data issue: false hasContentIssue false
  • English
  • Français

The cortisol awakening response predicts major depression: predictive stability over a 4-year follow-up and effect of depression history

Published online by Cambridge University Press:  01 June 2012

S. Vrshek-Schallhorn ,
L. D. Doane ,
S. Mineka ,
R. E. Zinbarg ,
M. G. Craske  and
E. K. Adam
S. Vrshek-Schallhorn*
Affiliation:
Department of Psychology, Northwestern University, Evanston, IL, USA
L. D. Doane
Affiliation:
Department of Psychology, Arizona State University, Tempe, AZ, USA
S. Mineka
Affiliation:
Department of Psychology, Northwestern University, Evanston, IL, USA
R. E. Zinbarg
Affiliation:
Department of Psychology, Northwestern University, Evanston, IL, USA The Family Institute at Northwestern University, Evanston, IL, USA
M. G. Craske
Affiliation:
Department of Psychology, University of California, Los Angeles (UCLA), Los Angeles, CA, USA
E. K. Adam
Affiliation:
School of Education and Social Policy, Northwestern University, Evanston, IL, USA Cells to Society Center, Institute for Policy Research, Northwestern University, Evanston, IL, USA
*
*Address for correspondence: S. Vrshek-Schallhorn, Ph.D., Department of Psychology, Northwestern University, 2029 Sheridan Road, Evanston, IL 60208, USA. (Email: suzanne.schallhorn@gmail.com)
Get access Rights & Permissions [Opens in a new window]

Abstract

Background

The cortisol awakening response (CAR) has been shown to predict major depressive episodes (MDEs) over a 1-year period. It is unknown whether this effect: (a) is stable over longer periods of time; (b) is independent of prospective stressful life events; and (c) differentially predicts first onsets or recurrences of MDEs.

Method

A total of 270 older adolescents (mean age 17.06 years at cortisol measurement) from the larger prospective Northwestern-UCLA Youth Emotion Project completed baseline diagnostic and life stress interviews, questionnaires, and a 3-day cortisol sampling protocol measuring the CAR and diurnal rhythm, as well as up to four annual follow-up interviews of diagnoses and life stress.

Results

Non-proportional person-month survival analyses revealed that higher levels of the baseline CAR significantly predict MDEs for 2.5 years following cortisol measurement. However, the strength of prediction of depressive episodes significantly decays over time, with the CAR no longer significantly predicting MDEs after 2.5 years. Elevations in the CAR did not significantly increase vulnerability to prospective major stressful life events. They did, however, predict MDE recurrences more strongly than first onsets.

Conclusions

These results suggest that a high CAR represents a time-limited risk factor for onsets of MDEs, which increases risk for depression independently of future major stressful life events. Possible explanations for the stronger effect of the CAR for predicting MDE recurrences than first onsets are discussed.

Keywords

Cortisol awakening responsediurnal rhythmlate adolescencemajor depressive disordernon-proportional hazards modelsstressful life events
Type
Original Articles
Information
Psychological Medicine , Volume 43 , Issue 3 , March 2013 , pp. 483 - 493
Copyright
Copyright © Cambridge University Press 2012

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Adam, E, Doane, L, Zinbarg, R, Mineka, S, Craske, M, Griffith, J (2010). Prospective prediction of major depressive disorder from cortisol awakening responses in adolescence. Psychoneuroendocrinology 35, 921–931.CrossRefGoogle ScholarPubMed
Adam, E, Gunnar, M (2001). Relationship functioning and home and work demands predict individual differences in diurnal cortisol patterns in women. Psychoneuroendocrinology 26, 189–208.CrossRefGoogle ScholarPubMed
Adam, E, Hawkley, L, Kudielka, B, Cacioppo, J (2006). Day-to-day dynamics of experience–cortisol associations in a population-based sample of older adults. Proceedings of the National Academy of Sciences USA 103, 17058–17063.CrossRefGoogle Scholar
Boland, R, Keller, M (2009). Course and outcome of depression. In Handbook of Depression (ed. Gotlib, I. and Hammen, C.), pp. 23–44. Guilford Press: New York.Google Scholar
Carver, CS, White, TL (1994). Behavioral inhibition, behavioral activation, and affective responses to impending reward and punishment: the BIS/BAS scales. Journal of Personality and Social Psychology 67, 319–333.CrossRefGoogle Scholar
Chrousos, G, Gold, P (1992). The concepts of stress and stress system disorders: overview of physical and behavioral homeostasis. JAMA 267, 1244–1252.CrossRefGoogle ScholarPubMed
Clow, A, Hucklebridge, F, Stalder, T, Evans, P, Thorn, L (2010). The cortisol awakening response: more than a measure of HPA axis function. Neuroscience and Biobehavioral Reviews 35, 97–103.CrossRefGoogle ScholarPubMed
Costa, PT, Terracciano, A, McCrae, RR (2001). Gender differences in personality traits across cultures: robust and surprising findings. Journal of Personality and Social Psychology 81, 322–331.CrossRefGoogle ScholarPubMed
Cowen, P (2010). Not fade away: the HPA axis and depression. Psychological Medicine 40, 1–4.CrossRefGoogle ScholarPubMed
Cox, D (1972). Regression models and life-tables. Journal of the Royal Statistical Society Series B (Methodological) 34, 187–220.CrossRefGoogle Scholar
Doane, LD, Adam, EK, Mineka, S, Zinbarg, R, Craske, M, Griffith, J (in press). Are flatter diurnal cortisol rhythms associated with major depression and anxiety disorders in late adolescence? The role of life stress and daily negative emotion. Development and Psychopathology.Google Scholar
Dressendörfer, R, Kirschbaum, C, Rohde, W, Stahl, F, Strasburger, C (1992). Synthesis of a cortisol–biotin conjugate and evaluation as a tracer in an immunoassay for salivary cortisol measurement. Journal of Steroid Biochemistry and Molecular Biology 43, 683–692.CrossRefGoogle Scholar
Ehlert, U, Gaab, J, Heinrichs, M (2001). Psychoneuroendocrinological contributions to the etiology of depression, posttraumatic stress disorder, and stress-related bodily disorders: the role of the hypothalamus–pituitary–adrenal axis. Biological Psychology 57, 141–152.CrossRefGoogle Scholar
Eysenck, SBG, Eysenck, HJ, Barrett, P (1985). A revised version of the psychoticism scale. Personality and Individual Differences 6, 21–29.CrossRefGoogle Scholar
First, M, Spitzer, R, Gibbon, M, Williams, J (2001). Structured Clinical Interview for DSM-IV-TR Axis I Disorders-Non-Patient Edition. New York State Psychiatric Institute, Biometrics Research Department: New York.Google Scholar
Fries, E, Dettenborn, L, Kirschbaum, C (2009). The cortisol awakening response (CAR): facts and future directions. International Journal of Psychophysiology 72, 67–73.CrossRefGoogle ScholarPubMed
Gerritsen, L, Geerlings, M, Beekman, A, Deeg, D, Penninx, B, Comijs, H (2010). Early and late life events and salivary cortisol in older persons. Psychological Medicine 40, 1569–1578.CrossRefGoogle ScholarPubMed
Goldberg, L (1999). A broad-bandwidth, public domain, personality inventory measuring the lower-level facets of several five-factor models. In Personality Psychology in Europe (ed. Mervielde, I., Deary, I., De Fruyt, F. and Ostendorf, F.), pp. 7–28. Tilburg University Press: Tilburg, The Netherlands.Google Scholar
Goodyer, I, Croudace, T, Dudbridge, F, Ban, M, Herbert, J (2010). Polymorphisms in BDNF (Val66Met) and 5-HTTLPR, morning cortisol and subsequent depression in at-risk adolescents. British Journal of Psychiatry 197, 365–371.CrossRefGoogle ScholarPubMed
Goodyer, I, Tamplin, A, Herbert, J, Altham, P (2000). Recent life events, cortisol, dehydroepiandrosterone and the onset of major depression in high-risk adolescents. British Journal of Psychiatry 177, 499–504.CrossRefGoogle ScholarPubMed
Halligan, S, Herbert, J, Goodyer, I, Murray, L (2007). Disturbances in morning cortisol secretion in association with maternal postnatal depression predict subsequent depressive symptomatology in adolescents. Biological Psychiatry 62, 40–46.CrossRefGoogle ScholarPubMed
Hammen, C (1991). Generation of stress in the course of unipolar depression. Journal of Abnormal Psychology 100, 555–561.CrossRefGoogle ScholarPubMed
Hammen, C, Adrian, C, Gordon, D, Burge, D, Jaenicke, C, Hiroto, D (1987). Children of depressed mothers: maternal strain and symptom predictors of dysfunction. Journal of Abnormal Psychology 96, 190–198.CrossRefGoogle ScholarPubMed
Harris, T, Borsanyi, S, Messari, S, Stanford, K, Brown, G, Cleary, S, Shiers, H, Herbert, J (2000). Morning cortisol as a risk factor for subsequent major depressive disorder in adult women. British Journal of Psychiatry 177, 505–510.CrossRefGoogle ScholarPubMed
Hollingshead, A (1975). Four Factor Index of Social Status. Yale University: New Haven, CT.Google Scholar
Holsboer, F (2000). The corticosteroid receptor hypothesis of depression. Neuropsychopharmacology 23, 477–501.CrossRefGoogle ScholarPubMed
Kendler, K, Karkowski, L, Prescott, C (1999). Causal relationship between stressful life events and the onset of major depression. American Journal of Psychiatry 156, 837–841.CrossRefGoogle ScholarPubMed
Kendler, K, Kuhn, J, Prescott, C (2004). The interrelationship of neuroticism, sex, and stressful life events in the prediction of episodes of major depression. American Journal of Psychiatry 161, 631–636.CrossRefGoogle ScholarPubMed
Meewisse, ML, Reitsma, JB, De Vries, GJ, Gersons, BPR, Olff, M (2007). Cortisol and post-traumatic stress disorder in adults: systematic review and meta-analysis. British Journal of Psychiatry 191, 387–392.CrossRefGoogle ScholarPubMed
Post, R (1992). Transduction of psychosocial stress into the neurobiology of recurrent affective disorder. American Journal of Psychiatry 149, 999–1010.Google ScholarPubMed
Pruessner, J, Wolf, O, Hellhammer, D, Buske-Kirschbaum, A, Von Auer, K, Jobst, S, Kaspers, F, Kirschbaum, C (1997). Free cortisol levels after awakening: a reliable biological marker for the assessment of adrenocortical activity. Life Sciences 61, 2539–2549.CrossRefGoogle ScholarPubMed
Saucier, G (1994). Mini-markers: a brief version of Goldberg's unipolar big-five markers. Journal of Personality Assessment 63, 506–516.CrossRefGoogle ScholarPubMed
Shirtcliff, EA, Essex, MJ (2008). Concurrent and longitudinal associations of basal and diurnal cortisol with mental health symptoms in early adolescence. Developmental Psychobiology 50, 690–703.CrossRefGoogle ScholarPubMed
Singer, J, Willett, J (2003). Applied Longitudinal Data Analysis: Modeling Change and Event Occurrence. Oxford University Press: New York.CrossRefGoogle Scholar
Wilhelm, I, Born, J, Kudielka, B, Schlotz, W, Wüst, S (2007). Is the cortisol awakening rise a response to awakening? Psychoneuroendocrinology 32, 358–366.CrossRefGoogle Scholar
Zinbarg, R, Mineka, S, Craske, M, Griffith, J, Sutton, J, Rose, R, Nazarian, M, Mor, N, Waters, A (2010). The Northwestern-UCLA Youth Emotion Project: associations of cognitive vulnerabilities, neuroticism and gender with past diagnoses of emotional disorders in adolescents. Behaviour Research and Therapy 48, 347–358.CrossRefGoogle ScholarPubMed