title: Salivary alpha-amylase response following repeated psychosocial stress in patients with panic disorder.
abstract: BACKGROUND
  This study examined autonomic responses (salivary alpha-amylase, sAA; heart rate, HR) to repeated psychosocial stress as a candidate mechanism linking autonomic hyper-arousal and sensitization to the occurrence of panic disorder (PD).
  
  
  METHODS
  Thirty-three patients with PD and 34 healthy controls were exposed to the Trier Social Stress Test (TSST) twice on consecutive days.
  
  
  RESULTS
  sAA changes were comparable between PD and controls on both testing days with overall decreasing sAA responses (delta) on day two. In contrast, HR delta increased on day two in both groups. This sensitization was driven by female controls while male PD showed most pronounced HR changes to the first TSST.
  
  
  CONCLUSIONS
  Overall, a general autonomic hyper-arousal in PD could not be confirmed. In contrast, sAA responses slightly habituated to repeated stress. Whether sAA findings mirror assumed habituation effects of repeated stress exposure on normalizing autonomic reactivity remains to be investigated in longitudinal studies.
authors.affiliation: Department of Psychotherapy and Psychosomatic Medicine, Medizinische Fakultät Carl Gustav Carus, Technische Universität Dresden, Germany. Electronic address: katja.petrowski@mailbox.tu-dresden.de.
authors.forename: Katja
authors.initials: K
authors.lastname: Petrowski
authors.affiliation: Department of Psychotherapy and Psychosomatic Medicine, Medizinische Fakultät Carl Gustav Carus, Technische Universität Dresden, Germany.
authors.forename: Gloria-Beatrice
authors.initials: GB
authors.lastname: Wintermann
authors.affiliation: Biological Psychology, Department of Psychology, Technische Universität Dresden, Germany.
authors.forename: Clemens
authors.initials: C
authors.lastname: Kirschbaum
authors.affiliation: Clinical Biopsychology, Department of Psychology, Philipps-Universität Marburg, Germany.
authors.forename: Jana
authors.initials: J
authors.lastname: Strahler
mesh_terms: D000293:Adolescent; D000328:Adult; D000704:Analysis of Variance; D001143:Arousal / Q000502:physiology; D001341:Autonomic Nervous System / Q000502:physiology; D015415:Biomarkers / Q000378:metabolism; D016022:Case-Control Studies; D005260:Female; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D006854:Hydrocortisone / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D016584:Panic Disorder / Q000378:metabolism / Q000523:psychology*; D012463:Saliva / Q000201:enzymology*; D055291:Salivary alpha-Amylases / Q000378:metabolism*; D013315:Stress, Psychological / Q000378:metabolism / Q000523:psychology*; D055815:Young Adult
chemical_list: D015415:Biomarkers; D055291:Salivary alpha-Amylases; D006854:Hydrocortisone
keywords: Autonomic nervous system; Heart rate; Panic disorder; Salivary alpha-amylase; Stress reactivity; TSST