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Sensitivity to stress among the offspring of parents with bipolar disorder: a study of daytime cortisol levels

  • C. S. Ostiguy (a1), M. A. Ellenbogen (a1), C.-D. Walker (a2), E. F. Walker (a3) and S. Hodgins (a4) (a5) (a6)...
Abstract
Background

It is well known that the hypothalamic–pituitary–adrenal (HPA) axis is compromised in major depression and bipolar disorder. There is increasing evidence that subtle HPA abnormalities, such as elevated cortisol levels, precede the development of an affective disorder. Interpersonal stress is also associated with the development of affective disorders. The present study sought to determine whether interpersonal chronic and episodic stress moderated the relationship between cortisol levels in the natural environment and risk status, defined as having a parent with bipolar disorder.

Method

Sixty-two offspring of parents with bipolar disorder (OBD) and 60 offspring with no family history of affective disorders (OFH−), aged 19.48 years (s.d.=3.38, range 14–28), completed interviews assessing mental disorders and chronic and episodic stress, and provided saliva samples over 3 days.

Results

Regression analyses revealed that the OBD who experienced high interpersonal chronic stress displayed a larger cortisol rise following awakening than the OBD reporting low interpersonal chronic stress. The same relationship was also found for levels of non-interpersonal chronic stress. The OBD who reported experiencing severe interpersonal episodic stress exhibited higher levels of daytime cortisol than the OBD reporting interpersonal episodic stress of mild severity. Importantly, none of the above relationships were detected in the OFH−. Each of the interactions between family history of affective disorders and stress remained after controlling for age, gender and offspring lifetime affective disorders and current non-affective disorders.

Conclusions

A biological sensitivity to stress may underlie the susceptibility to affective disorders among the OBD.

Copyright
Corresponding author
*Address for correspondence: M. A. Ellenbogen, Ph.D., Concordia University, Department of Psychology, 7141 Sherbrooke W., Montréal, QC, Canada H4B 1R6. (Email: mark.ellenbogen@concordia.ca)
References
Hide All
Adrian C, Hammen C (1993). Stress exposure and stress generation in children of depressed mothers. Journal of Consulting and Clinical Psychology 61, 354359.
Aiken L, West SG (1991). Multiple Regression: Testing and Interpreting Interactions. Sage Publications, Inc.: Thousand Oaks, CA.
Alloy LB, Abramson LY, Walshaw PD, Keyser J, Gerstein RK (2006). A cognitive vulnerability-stress perspective on bipolar spectrum disorders in a normative adolescent brain, cognitive, and emotional development context. Development and Psychopathology 18, 10551103.
Ashman SB, Dawson G, Panagiotides H, Yamada E, Wilkinson CW (2002). Stress hormone levels of children of depressed mothers. Development and Psychopathology 14, 333349.
Bhagwagar Z, Hafizi S, Cowen PJ (2005). Increased salivary cortisol after waking in depression. Psychopharmacology 182, 5457.
Birmaher B, Axelson D, Monk K, Kalas C, Goldstein B, Hickey MB, Obreja M, Ehmann M, Iyengar S, Shamseddeen W, Kupfer D, Brent D (2009). Lifetime psychiatric disorders in school-aged offspring of parents with bipolar disorder: the Pittsburgh Bipolar Offspring study. Archives of General Psychiatry 66, 287296.
Caspi A, Sugden K, Moffitt TE, Taylor A, Craig IW, Harrington H, McClay J, Mill J, Martin J, Braithwaite A, Poulton R (2003). Influence of life stress on depression: moderation by a polymorphism in the 5-HTT gene. Science 301, 386389.
Chang KD, Blasey C, Ketter TA, Steiner H (2001). Family environment of children and adolescents with bipolar parents. Bipolar Disorders 3, 7378.
Chida Y, Steptoe A (2009). Cortisol awakening response and psychosocial factors: a systematic review and meta-analysis. Biological Psychology 80, 265278.
Clow A, Thorn L, Evans P, Hucklebridge F (2004). The awakening cortisol response: methodological issues and significance. Stress 7, 2937.
de Kloet ER, Karst H, Joels M (2008). Corticosteroid hormones in the central stress response: quick-and-slow. Frontiers in Neuroendocrinology 29, 268272.
Eberhart NK, Hammen CL (2006). Interpersonal predictors of onset of depression during the transition to adulthood. Personal Relationships 13, 195206.
Edwards S, Clow A, Evans P, Hucklebridge F (2001). Exploration of the awakening cortisol response in relation to diurnal cortisol secretory activity. Life Sciences 68, 20932103.
Ellenbogen MA, Hodgins S (2004). The impact of high neuroticism in parents on children's psychosocial functioning in a population at high risk for major affective disorder: a family-environmental pathway of intergenerational risk. Development and Psychopathology 16, 113136.
Ellenbogen MA, Hodgins S (2009). Structure provided by parents in middle childhood predicts cortisol reactivity in adolescence among the offspring of parents with bipolar disorder and controls. Psychoneuroendocrinology 34, 773785.
Ellenbogen MA, Hodgins S, Linnen A-M, Ostiguy CS (2011). Elevated daytime cortisol levels: a biomarker of subsequent major affective disorders? Journal of Affective Disorders. Published online: 15 February 2011. doi: 10.1016/j.jad.2011.01.007.
Ellenbogen MA, Hodgins S, Walker CD, Couture S, Adam S (2006). Daytime cortisol and stress reactivity in the offspring of parents with bipolar disorder. Psychoneuroendocrinology 31, 11641180.
Ellenbogen MA, Santo JB, Linnen AM, Walker CD, Hodgins S (2010). High cortisol levels in the offspring of parents with bipolar disorder during two weeks of daily sampling. Bipolar Disorders 12, 7786.
Espejo EP, Hammen CL, Connolly NP, Brennan PA, Najman JM, Bor W (2006). Stress sensitization and adolescent depressive severity as a function of childhood adversity: a link to anxiety disorders. Journal of Abnormal Child Psychology 35, 287299.
Farmer A, Redman K, Harris T, Mahmood A, Sadler S, Pickering A, McGuffin P (2002). Neuroticism, extraversion, life events and depression. The Cardiff Depression Study. British Journal of Psychiatry 181, 118122.
First MB, Gibbon M, Spitzer RL, Williams JB (2001). Structured Clinical Interview for the DSM-IV-TR Axis I Disorders, Research Version, Patient Edition with Psychotic Screen. Biometrics Research, New York State Psychiatric Institute: New York.
Gallagher P, Watson S, Smith MS, Young AH, Ferrier IN (2007). Plasma cortisol-dehydroepiandrosterone (DHEA) ratios in schizophrenia and bipolar disorder. Schizophrenia Research 90, 258265.
Goodyer IM, Bacon A, Ban M, Croudace T, Herbert J (2009). Serotonin transporter genotype, morning cortisol and subsequent depression in adolescents. British Journal of Psychiatry 195, 3945.
Goodyer IM, Herbert J, Tamplin A, Altham PM (2000). Recent life events, cortisol, dehydroepiandrosterone and the onset of major depression in high-risk adolescents. British Journal of Psychiatry 177, 499504.
Gotlib IH, Joormann J, Minor KL, Hallmayer J (2008). HPA axis reactivity: a mechanism underlying the associations among 5-HTTLPR, stress, and depression. Biological Psychiatry 63, 847851.
Halligan SL, Herbert J, Goodyer IM, Murray L (2004). Exposure to postnatal depression predicts elevated cortisol in adolescent offspring. Biological Psychiatry 55, 376381.
Hammen C (1991). Generation of stress in the course of unipolar depression. Journal of Abnormal Psychology 100, 555561.
Hammen C (2003). Social stress and women's risk for recurrent depression. Archives of Women's Mental Health 6, 9–13.
Hammen C (2005). Stress and depression. Annual Review of Clinical Psychology 1, 293319.
Hammen C, Kim EY, Eberhart NK, Brennan PA (2009). Chronic and acute stress and the prediction of major depression in women. Depression and Anxiety 26, 718723.
Hammen C, Shih J, Altman T, Brennan PA (2003). Interpersonal impairment and the prediction of depressive symptoms in adolescent children of depressed and nondepressed mothers. Journal of the American Academy of Child and Adolescent Psychiatry 42, 571577.
Hankin BL (2008). Cognitive vulnerability-stress model of depression during adolescence: investigating depressive symptom specificity in a multi-wave prospective study. Journal of Abnormal Child Psychology 36, 999–1014.
Hankin BL, Badanes LS, Abela JR, Watamura SE (2010). Hypothalamic-pituitary-adrenal axis dysregulation in dysphoric children and adolescents: cortisol reactivity to psychosocial stress from preschool through middle adolescence. Biological Psychiatry 68, 484490.
Heim C, Owens MJ, Plotsky PM, Nemeroff CB (1997). Persistent changes in corticotropin-releasing factor systems due to early life stress: relationship to the pathophysiology of major depression and post-traumatic stress disorder. Psychopharmacology Bulletin 33, 185192.
Hillegers MH, Burger H, Wals M, Reichart CG, Verhulst FC, Nolen WA, Ormel J (2004). Impact of stressful life events, familial loading and their interaction on the onset of mood disorders: study in a high-risk cohort of adolescent offspring of parents with bipolar disorder. British Journal of Psychiatry 185, 97–101.
Ising M, Lauer CJ, Holsboer F, Modell S (2005). The Munich vulnerability study on affective disorders: premorbid neuroendocrine profile of affected high-risk probands. Journal of Psychiatric Research 39, 2128.
Kaufman J, Birmaher B, Brent D, Rao U (1997). Schedule for Affective Disorders and Schizophrenia for School-Age Children – Present and Lifetime version (K-SADS-PL): initial reliability and validity data. Journal of the American Academy of Child and Adolescent Psychiatry 36, 980988.
Kendler KS, Karkowski LM, Prescott CA (1999). Causal relationship between stressful life events and the onset of major depression. American Journal of Psychiatry 156, 837841.
Kendler KS, Karkowski-Shuman L (1997). Stressful life events and genetic liability to major depression: genetic control of exposure to the environment? Psychological Medicine 27, 539547.
Kendler KS, Kuhn JW, Vittum J, Prescott CA, Riley B (2005). The interaction of stressful life events and a serotonin transporter polymorphism in the prediction of episodes of major depression: a replication. Archives of General Psychiatry 62, 529535.
Kessler RC (1997). The effects of stressful life events on depression. Annual Review of Psychology 48, 191214.
Kim EY, Miklowitz DJ, Biuckians A, Mullen K (2007). Life stress and the course of early-onset bipolar disorder. Journal of Affective Disorders 99, 3744.
Kupper N, de Geus EJ, van den Berg M, Kirschbaum C, Boomsma DI, Willemsen G (2005). Familial influences on basal salivary cortisol in an adult population. Psychoneuroendocrinology 30, 857868.
Lapalme M, Hodgins S, LaRoche C (1997). Children of parents with bipolar disorder: a metaanalysis of risk for mental disorders. Canadian Journal of Psychiatry 42, 623631.
Lundy B, Jones N, Field T, Nearing G, Davalos M, Pietro P, Schanberg S, Kuhn C (1999). Prenatal depression effects on neonates. Infant Behavior and Development 22, 119129.
Lupien SJ, King S, Meaney MJ, McEwen BS (2000). Child's stress hormone levels correlate with mother's socioeconomic status and depressive state. Biological Psychiatry 48, 976980.
Mannie ZN, Harmer CJ, Cowen PJ (2007). Increased waking salivary cortisol levels in young people at familial risk of depression. American Journal of Psychiatry 164, 617621.
Marin TJ, Martin TM, Blackwell E, Stetler C, Miller GE (2007). Differentiating the impact of episodic and chronic stressors on hypothalamic-pituitary-adrenocortical axis regulation in young women. Health Psychology 26, 447455.
Mazure CM (1998). Life stressors as risk factors in depression. Clinical Psychology: Science and Practice 5, 291313.
McEwen BS (2008). Central effects of stress hormones in health and disease: understanding the protective and damaging effects of stress and stress mediators. European Journal of Pharmacology 583, 174185.
McGonagle KA, Kessler RC (1990). Chronic stress, acute stress, and depressive symptoms. American Journal of Community Psychology 18, 681706.
Meinlschmidt G, Heim C (2005). Decreased cortisol awakening response after early loss experience. Psychoneuroendocrinology 30, 568576.
Meyer SE, Chrousos GP, Gold PW (2001). Major depression and the stress system: a life span perspective. Development and Psychopathology 13, 565580.
Modell S, Lauer CJ, Schreiber W, Huber J, Krieg JC, Holsboer F (1998). Hormonal response pattern in the combined DEX-CRH test is stable over time in subjects at high familial risk for affective disorders. Neuropsychopharmacology 18, 253262.
O'Connor TG, Ben-Shlomo Y, Heron J, Adams D, Glover V, Golding J (2005). Prenatal anxiety predicts individual differences in cortisol in pre-adolescent children. Biological Psychiatry 58, 211217.
Ostiguy CS, Ellenbogen MA, Hodgins S (in press). Personality of parents with bipolar disorder and interpersonal functioning among their offspring: a prospective 10-year study. Development and Psychopathology.
Ostiguy CS, Ellenbogen MA, Linnen AM, Walker EF, Hammen C, Hodgins S (2009). Chronic stress and stressful life events in the offspring of parents with bipolar disorder. Journal of Affective Disorders 114, 7484.
Pajer K, Gardner W, Rubin RT, Perel J, Neal S (2001). Decreased cortisol levels in adolescent girls with conduct disorder. Archives of General Psychiatry 58, 297302.
Pruessner JC, Hellhammer DH, Kirschbaum C (1999). Burnout, perceived stress, and cortisol responses to awakening. Psychosomatic Medicine 61, 197204.
Pruessner JC, Kirschbaum C, Meinlschmid G, Hellhammer DH (2003). Two formulas for computation of the area under the curve represent measures of total hormone concentration versus time-dependent change. Psychoneuroendocrinology 28, 916931.
Sapolsky RM, Romero LM, Munck AU (2000). How do glucocorticoids influence stress responses? Integrating permissive, suppressive, stimulatory, and preparative actions. Endocrine Reviews 21, 5589.
Schmider J, Lammers CH, Gotthardt U, Dettling M, Holsboer F, Heuser IJ (1995). Combined dexamethasone/corticotropin-releasing hormone test in acute and remitted manic patients, in acute depression, and in normal controls: I. Biological Psychiatry 38, 797802.
Schreiber JE, Shirtcliff E, Van Hulle C, Lemery-Chalfant K, Klein MH, Kalin NH, Essex MJ, Goldsmith HH (2006). Environmental influences on family similarity in afternoon cortisol levels: twin and parent-offspring designs. Psychoneuroendocrinology 31, 11311137.
Seeman TE, McEwen BS (1996). Impact of social environment characteristics on neuroendocrine regulation. Psychosomatic Medicine 58, 459471.
Spitzer RL, Williams JB, Gibbon M, First MB (1992). The Structured Clinical Interview for DSM-III-R (SCID). I: History, rationale, and description. Archives of General Psychiatry 49, 624629.
Stetler C, Miller GE (2008). Social integration of daily activities and cortisol secretion: a laboratory based manipulation. Journal of Behavioral Medicine 31, 249257.
Therrien F, Drapeau V, Lupien SJ, Beaulieu S, Dore J, Tremblay A, Richard D (2008). Awakening cortisol response in relation to psychosocial profiles and eating behaviors. Physiology and Behavior 93, 282288.
Wals M, Hillegers MH, Reichart CG, Verhulst FC, Nolen WA, Ormel J (2005). Stressful life events and onset of mood disorders in children of bipolar parents during 14-month follow-up. Journal of Affective Disorders 87, 253263.
Weaver IC, Cervoni N, Champagne FA, D'Alessio AC, Sharma S, Seckl JR, Dymov S, Szyf M, Meaney MJ (2004). Epigenetic programming by maternal behavior. Nature Neuroscience 7, 847854.
Wichers M, Geschwind N, Jacobs N, Kenis G, Peeters F, Derom C, Thiery E, Delespaul P, van Os J (2009). Transition from stress sensitivity to a depressive state: longitudinal twin study. British Journal of Psychiatry 195, 498503.
Wüst S, Federenko IS, Van Rossum EFC, Kumsta R, Hellhammer DH, Entringer S, Koper JW, Yehuda R, McEwen B (2004). A psychobiological perspective on genetic determinants of hypothalamus-pituitary-adrenal axis activity. Annals of the New York Academy of Sciences 1032, 5262.
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