title: Effects of mood and rumination on cortisol levels in daily life: an ambulatory assessment study in remitted depressed patients and healthy controls.
abstract: The influence of naturally occurring emotional and cognitive experiences on hypothalamic-pituitary-adrenal axis (HPAA) activity is still underinvestigated, particularly in clinical populations. The present study examined effects of mood and rumination on cortisol levels in daily life in remitted depressed patients with recurrent episodes or a chronic precourse (n=31) and healthy controls (n=32). Ambulatory assessment of subjective variables (valence, calmness, energetic-arousal, ruminative self-focus), daily stressors, and saliva cortisol samples was performed five times a day on two consecutive workdays, whereby cortisol was collected 20min after the subjective assessments. In addition, depressive symptoms and trait rumination (brooding, reflection) were measured retrospectively. Multilevel models revealed that remitted depressed patients showed lower cortisol activity compared to healthy controls. Depressive symptoms and trait rumination did not predict HPAA activity, whereas, by controlling for daily stressors, higher daily means of ruminative self-focus and lower daily means of valence, energetic arousal and calmness were associated with higher daily cortisol levels. Separate analyses per group revealed that mean daily ruminative self-focus predicted higher cortisol in both samples. In contrast, lower daily means of calmness, but also of valence and energetic arousal, were significantly linked to higher cortisol output only in healthy controls, but not in the patient sample. These findings indicate that naturally occurring rumination and low mood are associated with increased activation of the HPAA in daily life. Moreover, our data revealed a potentially reduced mood-cortisol coupling in remitted recurrent depression, possibly indicating that during the course of recurrent depression HPAA activation might become less responsive toward subtle emotional experiences in natural contexts.
authors.affiliation: Research Group Longitudinal and Intervention Research, Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Germany. Electronic address: silke.huffziger@zi-mannheim.de.
authors.forename: Silke
authors.initials: S
authors.lastname: Huffziger
authors.forename: Ulrich
authors.initials: U
authors.lastname: Ebner-Priemer
authors.forename: Vera
authors.initials: V
authors.lastname: Zamoscik
authors.forename: Iris
authors.initials: I
authors.lastname: Reinhard
authors.forename: Peter
authors.initials: P
authors.lastname: Kirsch
authors.forename: Christine
authors.initials: C
authors.lastname: Kuehner
mesh_terms: D000203:Activities of Daily Living / Q000523:psychology*; D000293:Adolescent; D000328:Adult; D000339:Affect / Q000502:physiology*; D016022:Case-Control Studies; D003863:Depression / Q000378:metabolism* / Q000534:rehabilitation; D001068:Feeding and Eating Disorders / Q000378:metabolism*; D005260:Female; D006262:Health; D006801:Humans; D006854:Hydrocortisone / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D011602:Psychophysiologic Disorders / Q000378:metabolism*; D012074:Remission Induction; D055815:Young Adult
chemical_list: D006854:Hydrocortisone
keywords: Basal cortisol; Daily life; Ecological momentary assessment; Experience sampling; HPA axis; Mood; Remitted depression; Rumination