HPA axis response to a psychological stressor in generalised social phobia

• Published in: Psychoneuroendocrinology Vol. 27; no. 6; pp. 693 - 703
• Main Authors: Condren, R.M., O'Neill, A., Ryan, M.C.M., Barrett, P., Thakore, J.H.
• Format: Journal Article
• Language: English
• Published: Oxford Elsevier Ltd 01.08.2002; Elsevier
• Subjects: Adrenal Glands - physiopathology; Adrenocorticotropic Hormone - blood; Adult; Anxiety - physiopathology; Behavioral psychophysiology; Biological and medical sciences; Corticotropin; Corticotropin releasing factor; Cortisol; Female; Fundamental and applied biological sciences. Psychology; Hormones and behavior; Humans; Hydrocortisone - blood; Hypothalamus - physiopathology; Male; Mental arithmetic; Middle Aged; Personality. Affectivity; Phobic Disorders - physiopathology; Pituitary Gland - physiopathology; Psychological stressor; Psychology. Psychoanalysis. Psychiatry; Psychology. Psychophysiology; Social phobia; Stress; Stress, Psychological - physiopathology; Psychological stressor; Cortisol; Social phobia; Corticotropin; Mental arithmetic; Corticotropin releasing factor; Human; Affect affectivity; Hypothalamohypophysoadrenal axis; Cognition; Experimental study; Hydrocortisone; Glucocorticoid; Stress; Acquisition process; Adrenocorticotropic hormone; Adenohypophyseal hormone; Adrenal hormone; Problem solving; Anxiety; Working memory
• ISSN: 0306-4530; 1873-3360
• DOI: 10.1016/S0306-4530(01)00070-1

Social phobia may be associated with a dysfunction of the hypothalamic–pituitary–adrenal (HPA) axis. In this study we determined HPA axis responsivity to a psychological stressor in patients with social phobia and compared them to healthy controls. Fifteen patients with DSM IV social phobia with a mean score of 77.7 on the Liebowitz Social Anxiety Scale and 15 age and sex matched controls underwent the stressor consisting of mental arithmetic and a short term memory test performed in front of an audience. Plasma levels of cortisol and corticotropin were measured at various intervals throughout the test. Although baseline measures of cortisol did not differ between patients (319.8±34.6 nmol/l) and controls (279.5±42.7 nmol/l)( t=0.7, df=28, P<0.5) nor did baseline corticotropin values (8.6±2.1 pg/ml vs 13.7±2.0 pg/ml respectively) ( t=−1.8, df=28, P<0.08) this stressor resulted in a significantly greater delta max cortisol response (the difference between baseline values and the maximum increase during the stressor) in patients (167.1±23.7 nmol/l) than in controls (106.7±16 nmol/l) ( t=2.1, df=28, P<0.04). There was no significant difference in delta max corticotropin between groups (patients 8.8±2.1 pg/ml vs controls 9.1±1.9 pg/ml) ( t=−0.08, df=28, P<0.9). This preliminary study indicates that patients with social phobia appear to have a hyper-responsive adrenocortical response to psychological stress.