城月 健太郎

Introduction: The hypothalamic-pituitary-adrenal axis is known to be related to abdominal symptoms, and the relationship between abdominal pain and cortisol secretory patterns has been previously investigated using a cross-sectional approach. Here, we investigated the effect of day-to-day variations in salivary cortisol and dehydroepiandrosterone-sulfate levels on abdominal symptoms in healthy individuals.Methods: Eleven college students (4 males and 7 females) participated in this study. The participants were asked to collect their saliva immediately after awakening and before bedtime for eight consecutive days. They also completed a questionnaire about abdominal symptoms before bedtime. The linear mixed model was applied to analyze the effects of the day-by-day variability or the 8-day average adrenal hormone level (at awakening, before bedtime, slope from awakening to bedtime) on abdominal symptoms.Results: The day-to-day variability of cortisol levels before bedtime was negatively related with loose stool, while the day-to-day variability of the cortisol slope was positively correlated with loose stool. A low 8-day average dehydroepiandrosterone-sulfate level at awakening was positively related with frequent bowel movements, loose stool, and long bouts of severe abdominal pain. Likewise, a low 8-day average dehydroepiandrosterone-sulfate slope was positively related with long bouts of abdominal pain.Conclusions: Low cortisol levels before bedtime and a steeper diurnal cortisol slope during the day may be related to bouts of diarrhea during the day. © 2010 Sugaya et al licensee BioMed Central Ltd.

The purpose of the present study was to examine Hypothalamus-Pituitary-Adrenal (HPA) axis reactivity in social anxiety. The present study used a standardized psychosocial stress protocol (the Trier Social Stress Test; TSST; [Kirschbaum, C.. Pirke, K.M., Hellhammer, D.H.. 1993. The 'Trier Social Stress Test'-a tool for investigating psychobiological stress responses in a laboratory setting. Neuropsychobiology 28, 76-81.]) with 11 higher-social-anxiety and 11 lower-social-anxiety male college students. Psychological responses and salivary cortisol and dehydroepiandrosterone (DHEA) reactivity and cortisol/DHEA ratio were assessed at seven different times. The results showed that there was a significantly lower cortisol responsiveness in the higher social anxiety group but there was no significant difference of DHEA responsiveness. Further analyses showed lower responses for the cortisol/DHEA ratio in the higher-social-anxiety group to the TSST. These results suggest that there may be reduced HPA axis reactivity to psychosocial stress in socially anxious people. (c) 2008 Elsevier B.V. All rights reserved.

This study investigates the effect of speech estimation on social anxiety to further understanding of this characteristic of Social Anxiety Disorder (SAD). In the first study, we developed the Speech Estimation Scale (SES) to assess negative estimation before giving a speech which has been reported to be the most fearful social situation in SAD. Undergraduate students (n = 306) completed a set of questionnaires, which consisted of the Short Fear of Negative Evaluation Scale (SFNE), the Social Interaction Anxiety Scale (SIAS), the Social Phobia Scale (SPS), and the SES. Exploratory factor analysis showed an adequate one-factor structure with eight items. Further analysis indicated that the SES had good reliability and validity. In the second study, undergraduate students (n = 315) completed the SFNE, SIAS, SPS, SES, and the Self-reported Depression Scale (SDS). The results of path analysis showed that fear of negative evaluation from others (FNE) predicted social anxiety, and speech estimation mediated the relationship between FNE and social anxiety. These results suggest that speech estimation might maintain SAD symptoms, and could be used as a specific target for cognitive intervention in SAD.

本研究では,社会不安障害の維持要因である,Cost/Probability biasを測定するSocial Cost/Probability scale (SCOP)を作成し,Cost/Probability biasの社会不安に与える影響について検討を行った.大学生362名を対象に質問紙調査を行い,「対人コミュニケーション」と「一般的社会的状況」の2因子からなるSCOPが作成された.さらに,SCOPの各因子についてクラスター分析を行ったところ,High Costクラスター,High Probabilityクラスター,Low Cost/Probabilityクラスターに分類された.分散分析を行った結果,High Costクラスターの社会不安の高いことが明らかにされた.以上から,SAD症状の改善にCost biasを低減させる認知療法などのアプローチの可能性が示唆された.

We investigated dehydroepiandrosterone (DHEA) secretion in response to acute psychosocial stress and the relations of DHEA secretion to cortisol secretion, cardiovascular activity, and negative mood changes. Thirty-three male students (mean age 22.6 years) were subjected to the psychosocial stress test "Trier Social Stress Test" (TSST), in which the participants were asked to deliver a speech and perform a mental arithmetic task in front of two audiences. Collections of saliva, measurements of blood pressure and heart rate, and assessments of negative mood by visual analog scales were conducted before, during, and after TSST. Acute psychosocial stress significantly increased salivary DHEA level by an average of 60% immediately after TSST. The peak of DHEA concentration preceded that of cortisol concentration by about 10min. DHEA response was moderately correlated to cortisol response (r=.34, r(s)=.49) but not to cardiovascular response. Lower DHEA level and elevated cortisol/DHEA ratio during TSST were significantly and moderately correlated with increased negative mood during and after TSST. These results indicated that an acute increase in DHEA concentration under stressful situations might be partly mediated by the activity of hypothalamus-pituitary-adrenal axis and could have some significance in the improvement of negative mood. (c) 2008 Elsevier B.V. All rights reserved.

本研究では,過敏性腸症候群(irritable bowel syndrome ; IBS)における心理社会的ストレス負荷時の副腎皮質ホルモン〔コルチゾールおよびデヒドロエピアンドロステロン(DHEA)〕,自律神経活動の反応を検討した.DHEAおよび自律神経指標についてはIBS群と統制群の差は認められなかったが,IBS群のコルチゾールの反応性は統制群よりも低下していた.本研究の結果から,IBS群において心理社会的ストレス負荷時のコルチゾールとDHEAの反応は一致していないことが示唆された.

近年，疾病予防などの観点からストレスの評価法に注目が集まっている．本稿では唾液を用いたストレス評価について概説した．人の唾液には様々なストレス関連物質が存在することがわかっており，非侵襲的なストレス評価法として利用できる可能性が考えられる．唾液採取，検体の取り扱い，測定などの基本的事項を紹介し，唾液より測定可能な 7 つの物質（コルチゾール，デヒドロエピアンドロステロン，テストステロン，クロモグラニン A，3-メトキシ-4-ハイドロキシフェニルグリコール，α アミラーゼ，分泌型免疫グロブリン A）の各種ストレスとの関連や使用の際の留意点を概観した．最後に目的や状況に応じた唾液によるストレス評価の方法や今後の課題について述べた．<br>

The effect of negative rumination on social anxiety was investigated. In addition, since Social Anxiety Disorder (SAD) patients also exhibit a high degree of comorbidity with mood disorders, therefore we also discussed the relation between SAD and depression. Participants were 343 undergraduate students who completed a set of question naires consisting of the Social Avoidance and Distress Scale (SADS), the Short Fear of Negative Evaluation scale (SFNE), the Negative Rumination Scale (NRS), and the Self-rating Depression Scale (SDS). The results showed a moderate positive correlation between SADS, SFNE, NRS, and SDS (p<.01). After controlling for SDS, there remained a significant correlation between SADS, SFNE, and NRS (p<.01). Results of path analysis indicated the validity of the negative rumination model of social anxiety (GFI=.999, AGFI=.989, RMSEA=.001). Furthermore, all path coefficients were significant (p<.001), suggesting that negative rumination enhanced social anxiety and depression. These findings implicated the effect of negative rumination in reinforcing SAD. The possibility of interventions to prevent negative rumination in SAD treatment was discussed.

Cortisol secretion after awakening, an index of hypothalamus-pituitary-adrenal axis activity, appears to be related to psychosocial stressors, or to symptoms caused by psychosocial stressors. The relationship between the quality, duration, and magnitude of psychosocial factors and cortisol secretion is however, unclear. Therefore, the effect of episodic stress associated with writing a graduation thesis on cortisol secretion after awakening was investigated. Saliva samples were collected from 10 undergraduate students at awakening, and 30, 45, and 60 min after awakening 1 month, 2 weeks, and a few days before the thesis submission and 1 week after the submission. They also completed the Short form of Profile of Moods Scale (POMS-S) on the night before each sampling. Results indicated that cortisol levels were higher a few days before the thesis submission compared to 1 month before submission. Scores of "Fatigue" and "Tension-Anxiety" in POMS-S were also higher a few days before submission. These results suggest that episodic stress associated with writing a graduation thesis caused an increase in cortisol levels after awakening. (c) 2007 Elsevier B.V. All rights reserved.