 
        |
Stress
precipitates depression. Depression, in turn, generates and exacerbates
life stress. Chronic stress and depression share common physiologic
processes, including perturbations of the hypothalamic pituitary-adrenal
(HPA) axis and potential disruption of the normal circadian rhythm of cortisol
secretion. Despite evidence to suggest that stress-induced
dysregulation of HPA axis plays a key role in the etiology and course of
depression, the specific relationships among stress, depression, and HPA
function over time have yet to be fully elucidated. The proposed
study will explore stress-depression relationships in a sample of depressed
patients at high risk for chronic life stress, i.e., depressed mothers
of psychiatrically ill children. Thirty depressed mothers taking
part in a psychosocial treatment trial will be recruited to provide salivary
cortisol samples over a two-day period, and to complete an acute stress
reactivity task and assessments of depression, anxiety, past and current
life stress, perceived stress and perceived social support at two time
points: baseline and post-treatment (16 weeks later) This project
will pilot the inclusion of a psychophysiologic stress assessment battery
within the context of our outpatient depression prevention clinic.
We hypothesize that depressed patients reporting both childhood trauma
and recent life stress will display the greatest basal and acute cortisol
release. We also hypothesize that patients receiving active interpersonal
psychotherapy will report a greater reduction in perceived stress and a
greater increase in perceived social support as compared with patients
receiving treatment as usual, and that these indicators will be associated
with cortisol outcomes at the post-treatment assessment. This project
will provide pilot data needed to support an RO1 application developed
to characterize the interplay of stress, depression, and HPA function among
chronically-burdened, depressed outpatients with treatment and over time.
 (PDF
VERSION)(MS
WORD VERSION) |
