John G Keilp1, Barbara H Stanley2, Sue R Beers3, Nadine M Melhem3, Ainsley K Burke2, Thomas B Cooper2, Maria A Oquendo2, David A Brent3, J John Mann2. 1. Department of Molecular Imaging and Neuropathology, New York State Psychiatric Institute, Columbia University College of Physicians and Surgeons, United States; Department of Psychiatry, Columbia University College of Physicians and Surgeons, United States. Electronic address: jgk13@columbia.edu. 2. Department of Molecular Imaging and Neuropathology, New York State Psychiatric Institute, Columbia University College of Physicians and Surgeons, United States; Department of Psychiatry, Columbia University College of Physicians and Surgeons, United States. 3. Department of Psychiatry, University of Pittsburgh School of Medicine, United States; Western Psychiatric Institute and Clinic, United States.
Abstract
BACKGROUND: Many, but not all studies of suicide attempters' cortisol response to stress-either social stress or pharmacological challenge-report an exaggerated response. Recent studies of resting baseline cortisol in past suicide attempters, however, have found lower baseline levels. METHODS: In this study, baseline salivary cortisols were obtained prior to a stress procedure from adults with lifetime diagnoses of a mood disorder (N=69), 31.9% of whom had made a prior suicide attempt. Data were collected during the piloting of this stress procedure, at various times of day and with/without an additional confederate in the room. RESULTS: Adjusting for procedural, demographic and clinical variables that affect salivary cortisol levels-including time of day of sampling, order of procedure with respect to other assessments, past alcohol abuse, current medication use, and bipolar diagnosis-past suicide attempters had lower baseline cortisol levels compared to non-attempters. LIMITATIONS: This is a pilot study with modest sample sizes using statistical, rather than experimental control of numerous variables affecting salivary cortisol levels. CONCLUSIONS: Results confirm previous studies. Low baseline cortisol levels have been associated with childhood adversity and externalizing disorders, suggesting a potential role in reducing inhibitions for risky and dangerous behaviors. Further research is needed to more fully characterize these associations and their role in suicidal behavior risk.
BACKGROUND: Many, but not all studies of suicide attempters' cortisol response to stress-either social stress or pharmacological challenge-report an exaggerated response. Recent studies of resting baseline cortisol in past suicide attempters, however, have found lower baseline levels. METHODS: In this study, baseline salivary cortisols were obtained prior to a stress procedure from adults with lifetime diagnoses of a mood disorder (N=69), 31.9% of whom had made a prior suicide attempt. Data were collected during the piloting of this stress procedure, at various times of day and with/without an additional confederate in the room. RESULTS: Adjusting for procedural, demographic and clinical variables that affect salivary cortisol levels-including time of day of sampling, order of procedure with respect to other assessments, past alcohol abuse, current medication use, and bipolar diagnosis-past suicide attempters had lower baseline cortisol levels compared to non-attempters. LIMITATIONS: This is a pilot study with modest sample sizes using statistical, rather than experimental control of numerous variables affecting salivary cortisol levels. CONCLUSIONS: Results confirm previous studies. Low baseline cortisol levels have been associated with childhood adversity and externalizing disorders, suggesting a potential role in reducing inhibitions for risky and dangerous behaviors. Further research is needed to more fully characterize these associations and their role in suicidal behavior risk.
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Authors: Kevin G Saulnier; Rupsha Singh; Kristina P Lenker; Susan L Calhoun; Fan He; Duanping Liao; Alexandros N Vgontzas; Edward O Bixler; Julio Fernandez-Mendoza Journal: Sleep Health Date: 2022-06-19
Authors: Barbara Stanley; Christina A Michel; Hanga C Galfalvy; John G Keilp; Mina M Rizk; Randall Richardson-Vejlgaard; Maria A Oquendo; J John Mann Journal: Psychiatry Res Date: 2019-07-16 Impact factor: 3.222
Authors: Liat Itzhaky; Hanga Galfalvy; John G Keilp; Ilana Gratch; Beth S Brodsky; Barbara H Stanley Journal: Psychiatry Date: 2020-02-18 Impact factor: 2.458