The role of glucocorticoids and corticotropin-releasing hormone regulation on anxiety symptoms and response to treatment

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Abstract

The stress response has been linked to the expression of anxiety and depression, but the mechanisms for these connections are under continued consideration. The activation and expression of glucocorticoids and CRH are variable and may hold important clues to individual experiences of mood disorders. This paper explores the interactions of glucocorticoids and CRH in the presentation of anxiety and depressive disorders in an effort to better describe their differing roles in each of these clinical presentations. In addition, it focuses on ways in which extra-hypothalamic glucocorticoids and CRH, often overlooked, may play important roles in the presentation of clinical disorders.

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Most cited references 49

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Psychobiological mechanisms of resilience and vulnerability: implications for successful adaptation to extreme stress.

Dennis Charney (2004)

Most research on the effects of severe psychological stress has focused on stress-related psychopathology. Here, the author develops psychobiological models of resilience to extreme stress. An integrative model of resilience and vulnerability that encompasses the neurochemical response patterns to acute stress and the neural mechanisms mediating reward, fear conditioning and extinction, and social behavior is proposed. Eleven possible neurochemical, neuropeptide, and hormonal mediators of the psychobiological response to extreme stress were identified and related to resilience or vulnerability. The neural mechanisms of reward and motivation (hedonia, optimism, and learned helpfulness), fear responsiveness (effective behaviors despite fear), and adaptive social behavior (altruism, bonding, and teamwork) were found to be relevant to the character traits associated with resilience. The opportunity now exists to bring to bear the full power of advances in our understanding of the neurobiological basis of behavior to facilitate the discoveries needed to predict, prevent, and treat stress-related psychopathology.

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Cortisol and post-traumatic stress disorder in adults: systematic review and meta-analysis.

Marie-Louise Meewisse, Johannes Reitsma, Giel-Jan de Vries … (2007)

Post-traumatic stress disorder (PTSD) has inconsistently been associated with lower levels of cortisol. To compare basal cortisol levels in adults with current PTSD and in people without psychiatric disorder. Systematic review and meta-analysis. Standardised mean differences (SMD) in basal cortisol levels were calculated and random-effects models using inverse variance weighting were applied. Across 37 studies, 828 people with PTSD and 800 controls did not differ in cortisol levels (pooled SMD=-0.12, 95% CI=-0.32 to 0.080). Subgroup analyses revealed that studies assessing plasma or serum showed significantly lower levels in people with PTSD than in controls not exposed to trauma. Lower levels were also found in people with PTSD when females were included, in studies on physical or sexual abuse, and in afternoon samples. Low cortisol levels in PTSD are only found under certain conditions. Future research should elucidate whether low cortisol is related to gender or abuse and depends on the measurement methods used.

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Transgenerational effects of posttraumatic stress disorder in babies of mothers exposed to the World Trade Center attacks during pregnancy.

Rachel Yehuda, Stephanie Mulherin Engel, Sarah R Brand … (2005)

Reduced cortisol levels have been linked with vulnerability to posttraumatic stress disorder (PTSD) and the risk factor of parental PTSD in adult offspring of Holocaust survivors. The purpose of this study was to report on the relationship between maternal PTSD symptoms and salivary cortisol levels in infants of mothers directly exposed to the World Trade Center collapse on September 11, 2001 during pregnancy. Mothers (n = 38) collected salivary cortisol samples from themselves and their 1-yr-old babies at awakening and at bedtime. Lower cortisol levels were observed in both mothers (F = 5.15, df = 1, 34; P = 0.030) and babies of mothers (F = 8.0, df = 1, 29; P = 0.008) who developed PTSD in response to September 11 compared with mothers who did not develop PTSD and their babies. Lower cortisol levels were most apparent in babies born to mothers with PTSD exposed in their third trimesters. The data suggest that effects of maternal PTSD related to cortisol can be observed very early in the life of the offspring and underscore the relevance of in utero contributors to putative biological risk for PTSD.

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Author and article information

Journal

Journal ID (nlm-ta): Endocr Connect

Journal ID (iso-abbrev): Endocr Connect

Journal ID (hwp): EC

Title: Endocrine Connections

Publisher: Bioscientifica Ltd (Bristol )

ISSN (Electronic): 2049-3614

Publication date Collection: February 2017

Publication date (Electronic): 24 January 2017

Volume: 6

Issue: 2

Pages: R1-R7

Affiliations

[1 ]Department of Psychology American University, Washington, District of Columbia, USA

[2 ]Department of Psychology Neuroscience & Behavior, McMaster University, Hamilton, Ontario, Canada

[3 ]Department of Research American College of Obstetricians and Gynecologists, Washington, District of Columbia, USA

[4 ]Department of Neuroscience Georgetown University, Washington, District of Columbia, USA

Author notes

Correspondence should be addressed to G B Raglan; Email: gb2799a@ 123456american.edu

Article

Publisher ID: EC160100

DOI: 10.1530/EC-16-0100

PMC ID: 5424777

PubMed ID: 28119322

SO-VID: 5fe63ad7-c95d-40bb-8606-732ed9ee9c31

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This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

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The role of glucocorticoids and corticotropin-releasing hormone regulation on anxiety symptoms and response to treatment

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Bioscientifica Open Endocrinology

Most cited references 49

Psychobiological mechanisms of resilience and vulnerability: implications for successful adaptation to extreme stress.

Cortisol and post-traumatic stress disorder in adults: systematic review and meta-analysis.

Transgenerational effects of posttraumatic stress disorder in babies of mothers exposed to the World Trade Center attacks during pregnancy.

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