Effects of perceived control and cognitive coping on endocrine stress responses to pharmacological activation.
BACKGROUND
The hypothalamic-pituitary-adrenal (HPA) axis may mediate negative health effects of stress. It is sensitive to cognitive/emotional factors like novelty, perceived control, and coping. Psychological intervention that reduces novelty and enhances cognitive coping and sense of control can reduce cortisol responses to pentagastrin, a pharmacological HPA activator. This study attempted to identify the core factors that modulate HPA axis activity in this model.


METHODS
Varying instructions were administered prior to drug exposure in a two-visit (placebo first) pentagastrin infusion paradigm. Healthy subjects (n = 40) were randomly assigned to one of four instruction groups: 1) standard instruction (SI); 2) full cognitive intervention (CI); 3) the CI control component alone; or 4) the CI novelty reduction/coping components alone. Blood samples were obtained via intravenous catheter before and after pentagastrin.


RESULTS
Subjects receiving an intervention had smaller cortisol responses than subjects receiving standard instructions. Coping alone had as strong an impact as the more complex intervention that combined coping and control. Control alone also reduced cortisol but its HPA impact appeared less robust.


CONCLUSIONS
Brief psychological manipulation can significantly reduce HPA activation in challenge paradigms. Cognitive preparation that focused on side effects, reduced potential surprise, and enhanced cognitive coping modulated HPA axis activity as effectively as a previously tested intervention that combined coping and control manipulations. A sense of control alone also reduced cortisol release. The results support development of control or coping techniques to combat negative health effects of stress that are mediated by HPA axis activation.
Department of Psychiatry, Trauma, Stress and Anxiety Research Group, Molecular and Behavioral Neuroscience Institute, University of Michigan, Ann Arbor, Michigan. Electronic address: jabelson@umich.edu.
James L
JL
Abelson
Department of Psychiatry, Trauma, Stress and Anxiety Research Group, Molecular and Behavioral Neuroscience Institute, University of Michigan, Ann Arbor, Michigan.
Samir
S
Khan
Department of Psychiatry, Trauma, Stress and Anxiety Research Group, Molecular and Behavioral Neuroscience Institute, University of Michigan, Ann Arbor, Michigan.
Israel
I
Liberzon
Department of Psychiatry, Trauma, Stress and Anxiety Research Group, Molecular and Behavioral Neuroscience Institute, University of Michigan, Ann Arbor, Michigan.
Thane M
TM
Erickson
Department of Psychiatry, Trauma, Stress and Anxiety Research Group, Molecular and Behavioral Neuroscience Institute, University of Michigan, Ann Arbor, Michigan.
Elizabeth A
EA
Young
D000223:Adaptation, Psychological / Q000187:drug effects / Q000502:physiology*; D000293:Adolescent; D000324:Adrenocorticotropic Hormone / Q000097:blood; D000328:Adult; D001008:Anxiety Disorders / Q000097:blood / Q000139:chemically induced / Q000523:psychology*; D019540:Area Under Curve; D001288:Attention / Q000502:physiology; D003071:Cognition / Q000502:physiology; D005260:Female; D005765:Gastrointestinal Agents / Q000494:pharmacology; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D007030:Hypothalamo-Hypophyseal System / Q000187:drug effects / Q000502:physiology; D007389:Internal-External Control; D008297:Male; D008875:Middle Aged; D010418:Pentagastrin / Q000494:pharmacology*; D010913:Pituitary-Adrenal System / Q000187:drug effects / Q000502:physiology; D043887:Receptor, Cholecystokinin B / Q000819:agonists; D021641:Recognition, Psychology / Q000502:physiology; D012016:Reference Values; D012720:Severity of Illness Index; D018709:Statistics, Nonparametric; D013315:Stress, Psychological / Q000097:blood / Q000139:chemically induced / Q000523:psychology*; D055815:Young Adult
D005765:Gastrointestinal Agents; D043887:Receptor, Cholecystokinin B; D000324:Adrenocorticotropic Hormone; D010418:Pentagastrin; D006854:Hydrocortisone