Alterations in HPA-axis and autonomic nervous system functioning in childhood anxiety disorders point to a chronic stress hypothesis

PSYCHONEUROENDOCRINOLOGY

卷:51

Article

Dieleman, Gwendolyn C.¹  Huizink, Anja C.²  Tulen, Joke H. M.³  Utens, Elisabeth M. W. J.¹  Creemers, Hanneke E.⁴  van der Ende, Jan¹  Verhulst, Frank C.¹ 

[1] Erasmus Med Ctr Rotterdam Sophia Childrens Hosp, Dept Child & Adolescent Psychiat Psychol, NL-3015 CN Rotterdam, Netherlands

[2] Vrije Univ Amsterdam, Dept Child Dev, Fac Psychol & Educ, Amsterdam, Netherlands

[3] Erasmus MC, Dept Psychiat, Rotterdam, Netherlands

[4] Univ Amsterdam, Fac Social & Behav Sci, Amsterdam, Netherlands

关键词: Anxiety disorder;    Autonomic nervous system;    Cortisol;    Child;    HPA-axis;    Psychophysiology;    Stress, Perceived arousal;    Comorbidity, Severity;   

DOI  :  10.1016/j.psyneuen.2014.09.002

来源: Elsevier

【 摘 要 】

Background: It is of debate whether or not childhood anxiety disorders (AD) can be captured by one taxonomic construct. This study examined whether perceived arousal (PA), autonomic nervous system (ANS) and hypothalamic-pituitary-adrenal (HPA) axis measures can distinguish children with different primary diagnoses of clinical anxiety disorders (AD) from each other, and from a general population reference group (GP). Methods: The study sample consisted of 152 AD children (comparing separation anxiety disorder, generalized anxiety disorder, social phobia and specific phobia), aged 8- to 12-years, and 200 same-aged reference children. HPA-axis functioning was measured by a diurnal cortisol profile. ANS functioning was measured by continuous measures of skin conductance level in rest and during a mental arithmetic task and high frequency heart rate variability in rest. PA was assessed by a questionnaire. Results: The AD sample showed lower high frequency heart rate variability during rest, heightened anticipatory PA, higher basal and reactive skin conductance levels and lower basal HPA-axis functioning compared to the GP sample. The existence of three or more clinical disorders, i.e. a high clinical 'load', was associated with lower basal HPA-axis functioning, higher skin conductance level and lower posttest PA. Specific phobia could be discerned from social phobia and separation anxiety disorder on higher skin conductance level. Conclusions: Our findings indicated that children with AD have specific psychophysiological characteristics, which resemble the psychophysiological characteristics of chronic stress. A high clinical 'load' is associated with an altered ANS and HPA-axis functioning. Overall, ANS and HPA-axis functioning relate to AD in general, accept for specific phobia. (C) 2014 Elsevier Ltd. All rights reserved.

【 授权许可】

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