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Summary: The present study assessed the modulating effect of education level on cortisol reactivity to the Trier Social Stress Test (TSST) in a sample of 101 middle-aged adults (22 males, 79 females) between the ages of 50 and 65. The TSST involves a public speech and mental arithmetic task in front of an audience. No previous studies have assessed whether education level can have an impact on cortisol reactivity to this psychosocial stressor. It is plausible that greater exposure to academia may impact how one perceives and responds to the demands of the speech and arithmetic task. Should education have an impact on cortisol reactivity to the TSST, future studies will be required to control for this factor in order to reduce both statistical error and false interpretations. In addition to completing the TSST, participants were administered a battery of neurocognitive tests and personality questionnaires, including a report on education level (i.e. number of years total and degree: High School, Junior College, Technical, University). Results showed that adults with post-secondary education above Junior College tended to secrete higher cortisol levels overall, as measured by total area under the curve. However, it was the group with lower educational attainment who showed a greater stress response specific to the TSST, as measured by percentage increase in cortisol from pre- to post-TSST. Analyses also found that higher educated adults performed better than their less educated peers on verbal fluency. Considering that the TSST is an oral task, it is suggested that middle-aged individuals with a lower level of education may find the TSST more stressful due to lower verbal capacity, which may lead to an increased cortisol response to the TSST when compared to individuals with a higher level of education. [Copyright &y& Elsevier]

Summary: Early life adversity has been associated with an increased risk for the development of mental health problems, including psychotic disorders, perhaps mediated by a changed regulation of the Hypothalamic Pituitary Adrenal (HPA) axis. Aim of the present study was to confirm our previous finding of an attenuated cortisol awakening response (CAR) in men with first episode psychosis (FEP) and to explore a possible link between a blunted CAR and early adversity as indicated by perceived parental bonding. Fifty-eight patients (38 men, 20 women; mean age 23.25±3.86) with a FEP and 33 healthy community controls (16 men, 17 women; mean age 22.91±3.64) participated in the study. Saliva samples for assessment of the CAR were collected immediately, 30 and 60min after awakening. Complete cortisol samples were available in a reduced sample of 56 patients (37 men) and 30 controls (13 men). Parental bonding during the first 16 years of life was assessed retrospectively with the Parental Bonding Inventory. Results showed a significantly blunted CAR in male compared to female patients, confirming our previously reported findings. We also found a lower CAR in the total FEP group compared to controls, which failed to reach significance after controlling for time of awakening. A significantly lower percentage of patients than controls reported optimal maternal parenting. Within the patient group, significantly fewer male than female patients reported optimal maternal and paternal parenting. Only in patients, unfavorable paternal parenting was related to a blunted CAR. Dysregulation of the HPA axis in male patients might be a consequence of non-optimal parenting and contribute to the less favorable course of psychosis in men compared to women. [ABSTRACT FROM AUTHOR]

Summary: Context: For the past two decades, researchers have shown that elevated levels of circulating stress hormones may negatively impact cognitive performance in older adults. As well, genetic polymorphism of the apolipoprotein E gene (APOE) has been found to contribute to impairment in cognitive performance in old age. To date, only one study has reported a relationship between APOE status and cortisol levels, however the relationship was only found to be significant in dementia patients, with a trend observed in healthy controls. Objective: The goal of the present investigation was to examine the acute and long-term relationship between APOE status, cortisol secretion, and declarative memory performance in older adults. Design: Two sample cohorts were assessed. In the first cohort, 24-h basal serum cortisol levels were obtained once a year over eight years to assess changes in basal cortisol levels over time. Declarative memory was also obtained in this group at three time-points over five years. In the second cohort, basal and stress-induced cortisol levels as well as basal declarative memory was tested. Results: In the first cohort, E4 carriers were found to secrete higher serum cortisol levels than non-E4 carriers during the first 24-h visit (p=0.04) to the laboratory. However, this group difference did not remain over subsequent years. Furthermore, declarative memory performance over years did not significantly differ according to APOE status. In the second cohort, no significant group differences were found for basal or reactive cortisol levels (ps>0.05), and no group difference was found for acute declarative memory performance. Conclusion: The findings in this study suggest minimal to no significant effect of APOE status on cortisol secretion or declarative memory in non-demented older adults. [Copyright &y& Elsevier]

• First episode psychosis patients show reduced baseline cortisol levels during the TSST. • Cortisol increase following the TSST is intact in first episode psychosis patients. • Lower cortisol levels during the TSST are associated with poor self-esteem and active coping skills. • Cortisol non-responders to the TSST had experienced more physical neglect during childhood. Psychosis has been associated with abnormalities in hypothalamic-pituitary-adrenal axis functioning, which may emerge through heightened stress sensitivity following early life adversity – ultimately resulting in illness onset and progression. The present study assessed cortisol levels during an established psychosocial stress task and their association with current stress perception, putative protective factors and adverse childhood experiences in patients with a first episode of psychosis (FEP). A total of 100 volunteers participated in the study, 57 of whom were patients with a FEP (mean age 23.9 ± 3.8) and 43 healthy community controls (mean age 23.2 ± 3.9). Salivary cortisol, heart rate and blood pressure were measured at eight time points before and after the Trier Social Stress Test. Subjective stress and protective factors were assessed with the Perceived Stress Scale, the Self-Esteem Rating Scale and the Brief COPE. Early life adversity was assessed with the Childhood Trauma Questionnaire. Patients compared to controls showed significantly lower cortisol levels (F = 7.38; p =.008) throughout the afternoon testing period, but no difference in the cortisol response to the TSST. Heart rate was elevated and protective factors were lower in patients compared to controls. Attenuated cortisol levels were associated with higher levels of perceived stress, poor protective factors and more physical neglect during childhood. Our results suggest that attenuated baseline cortisol levels and not a blunted response during an acute stress task might be an indicator of heightened stress vulnerability and poor resilience in psychosis. The possible influence of childhood adversity and antipsychotic medication is discussed. [ABSTRACT FROM AUTHOR]

Summary: Introduction: Intranasal oxytocin attenuates cortisol levels during social stress inductions. However, no research to date has documented the dose–response relation between intranasal oxytocin administration and cortisol, and researchers examining intranasal oxytocin have not examined the cortisol response to physical stress. We therefore examined the effects of 24IU and 48IU of intranasal oxytocin on the cortisol response to vigorous exercise. Method: Seventeen males participated in a randomized, placebo-controlled, double-blind, and within-subject experiment. Participants engaged in vigorous exercise for 60min following the administration of placebo or intranasal oxytocin on three occasions. Saliva samples and mood ratings were collected at eight intervals across each session. Results: Salivary cortisol concentrations changed over time, peaking after 60min of exercise (quadratic: F(1,16)=7.349, p =.015, partial η 2 =.32). The 24IU dose of oxytocin attenuated cortisol levels relative to placebo (F(1,16)=4.496, p =.05, partial η 2 =.22) and the 48IU dose, although the latter fell just short of statistical significance (F(1,16)=3.054, p =.10, partial η 2 =.16). There was no difference in the cortisol response to exercise in participants who were administered 48IU of intranasal oxytocin relative to placebo. Intranasal oxytocin had no effect on mood. Conclusion: This is the first study to demonstrate that the effect of intranasal oxytocin on salivary cortisol is dose-dependent, and that intranasal oxytocin attenuates cortisol levels in response to physical stress. Future research using exogenous oxytocin will need to consider the possibility of dose–response relations. [ABSTRACT FROM AUTHOR]

Summary: The administration of oxytocin promotes prosocial behavior in humans. The mechanism by which this occurs is unknown, but it likely involves changes in social information processing. In a randomized placebo-controlled study, we examined the influence of intranasal oxytocin and placebo on the interference control component of inhibition (i.e. ability to ignore task-irrelevant information) in 102 participants using a negative affective priming task with sad, angry, and happy faces. In this task, participants are instructed to respond to a facial expression of emotion while simultaneously ignoring another emotional face. On the subsequent trial, the previously-ignored emotional valence may become the emotional valence of the target face. Inhibition is operationalized as the differential delay between responding to a previously-ignored emotional valence and responding to an emotional valence unrelated to the previous one. Although no main effect of drug administration on inhibition was observed, a drug×depressive symptom interaction (β =−0.25; t =−2.6, p <0.05) predicted the inhibition of sad faces. Relative to placebo, participants with high depression scores who were administered oxytocin were unable to inhibit the processing of sad faces. There was no relationship between drug administration and inhibition among those with low depression scores. These findings are consistent with increasing evidence that oxytocin alters social information processing in ways that have both positive and negative social outcomes. Because elevated depression scores are associated with an increased risk for major depressive disorder, difficulties inhibiting mood-congruent stimuli following oxytocin administration may be associated with risk for depression. [ABSTRACT FROM AUTHOR]

Early psychosis is associated with elevated levels of subjective stress and abnormalities in hypothalamic-pituitary-adrenal axis functioning, including the blunting of cortisol stress response. However, it remains unknown whether this blunting is progressive or consistent across both clinical high-risk (CHR) and first episode psychosis (FEP) stages. In the context of clinical staging models, we examined cortisol response to the Trier Social Stress Test (TSST) between phases of early psychosis. We measured perceived stress and salivary cortisol before, during and after the TSST in individuals at CHR (n=28, mean age 19.1) and/or experiencing a FEP (n=60, mean age 22.9) compared with community controls (n=44, mean age 23.0). Compared with controls, perceived stress is higher (p<0.05) and salivary cortisol is blunted (p< 0.01) in the combined early psychosis (CHR+FEP) sample across the entire TSST measurement period, not only following the speaking task. There were no differences in perceived stress or cortisol between the CHR and FEP groups. Despite evidence of elevated levels of diurnal cortisol, cortisol response to acute stressors may nonetheless be blunted throughout early psychosis. With high perceived stress, the observed blunting may be the culmination of ongoing stress sensitization pre-psychosis – with implications for theories of stress vulnerability, and for biomarkers and clinical staging in emerging mental illness. [ABSTRACT FROM AUTHOR]

Summary: A dysregulation of the hypothalamus–pituitary–adrenal (HPA) axis has been suggested as a factor in the etiology and exacerbation of psychosis, but has not been reported consistently. Sex differences are apparent in many aspects of psychotic disorders and may explain some of the equivocation associated with the regulation of the HPA axis in the illness. The present study compared the cortisol response to awakening (CRA) in 27 patients (16 men and 11 women) with recent onset of psychosis (within the past 2 years) and 40 age and gender matched controls. Within the patient group, we also assessed the relationship between the CRA and positive and negative symptoms of psychosis, anxiety and depression. The CRA in patients was not significantly different from controls. However, within the patient group, we observed a significant sex difference, with a blunted cortisol response to awakening in men but not in women (F =7.26; p <0.002). This difference could not be explained by differences between male and female patients in awakening time, medication, or diagnosis of schizophrenia vs. affective psychosis. Cortisol levels were not related to symptom measures. Our findings demonstrate a dysregulation of the HPA axis in male patients with recent onset of psychosis. This sex specificity might be related to and explain in part the unfavorable course of the illness observed in men. [Copyright &y& Elsevier]

• First-episode psychosis patients have significantly different adipokine blood levels. • Adipokine changes were observed with null or minimal exposure to antipsychotics. • Resistin levels increased in association with childhood trauma scores. • Chemerin levels were significantly higher in patients with a minority background. • Adipose tissue dysregulation might be present in psychosis before antipsychotic use. Recent evidence suggests that patients with psychotic disorders have metabolic disturbances (e.g., insulin resistance, dyslipidemia) at the onset of the disease and before antipsychotic exposure. Such disturbances are strongly associated with adipose tissue dysregulation. Measuring adipokines, the molecular mediators of adipose function, could provide a picture of the state of metabolic regulation at the onset of psychosis. The present study explores adipokine changes in a population of first-episode psychosis (FEP) patients with minimal prior exposure to antipsychotics. The effects of social determinants of health (childhood trauma and minority status) associated with both metabolic and psychotic disorders were studied as potential determinants of this phenomenon. Data was collected through the Signature project, a biobank of clinical, socio-demographic, and biological markers. Adipokines (leptin, adiponectin, resistin and chemerin) were measured in serum of FEP patients with minimal exposure to antipsychotics (N = 48) and controls (N = 39). Data were analyzed with univariate (t -tests) and multivariate (linear regression) statistical methods. Patients, compared to controls, had significantly higher levels of adiponectin and resistin, and significantly lower levels of leptin and chemerin. These results persisted after controlling for sex, waist-to-height ratio, childhood trauma, and visible minority status. Adiponectin and chemerin retained their effects after further controlling for tobacco and depression. Resistin increased with childhood trauma scores; chemerin was higher in visible minority patients. Adipose tissue dysfunction is present in FEP patients, before exposure to antipsychotics. Social determinants of health contribute to adipose (and metabolic) dysregulation in FEP, but may not be the main determinants of this relationship. [ABSTRACT FROM AUTHOR]