Background: Little is known about the hypothalamic-pituitary-adrenal axis response to acute stressful behavioral challenges in patients with social phobia.
Methods: Eighteen patients with social phobia and 17 normal volunteers participated in two behavioral stressors: a speech task and physical exercise.
Results: Normal volunteers (n = 14) demonstrated a significant 50% increase in salivary cortisol levels to the speech task. Three nonresponding normal volunteers demonstrated a 17% decrease. In contrast, patients with social phobia demonstrated dichotomous changes. Seven social phobia patients demonstrated a significantly higher 90% increase in salivary cortisol to the speech task, whereas the remaining patients (n = 11) were nonresponders demonstrating a 32% decrease in cortisol. Both patient groups were significantly more anxious than the normal volunteers. In contrast to the response to a speech task, social phobics showed a cortisol response to physical exercise of similar magnitude as normal volunteers.
Conclusions: The results indicated dichotomies in magnitude and in distribution of the cortisol response to a speech task between social phobia patients and normal volunteers. Social phobia patients responded differently than normal volunteers to a stressor associated with social evaluation but not to physical exercise. These results suggest adaptation of distinct biological processes specific to different stressful conditions in social phobia.
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- Diagnostic and Statistical Manual of Mental Disorders. 4th ed. American Psychiatric Press, Washington, DC1994
- Psychometric properties of the Beck Depression Inventory.Clin Psychol Rev. 1988; 8: 77-100
- The boundary of social phobia.Arch Gen Psychiatry. 1994; 51: 975-983
- Behavioral, sympathetic and adrenocortical responses to yohimbine in panic disorder patients and normal controls.Psychiatry Res. 1997; 71: 27-39
- The social readjustment scale.J Psychosom Res. 1967; 11: 213-218
- Lifetime and 12-month prevalence of DSM-III-R psychiatric disorders in the United States. Results from the National Comorbidity Survey.Arch Gen Psychiatry. 1994; 51: 8-19
- Salivary cortisol in psychobiological research.Neuropsychobiology. 1989; 22: 150-169
- Reduction in urinary free cortisol during benzodiazepine treatment of panic disorder.Psychoneuroendocrinology. 1990; 15: 23-28
- Serotoninic receptor binding in a colony model of chronic social stress.Biol Psychiatry. 1995; 37: 383-393
- Levels of urinary free cortisol in social phobia.J Clin Psychiatry. 1991; 52: 41-42
- Effect of previous trauma on acute plasma cortisol level following rape.Am J Psychiatry. 1995; 152: 1675-1677
- The dexamethasone suppression test in generalised anxiety disorder.Br J Psychiatry. 1986; 149: 320-322
- Manual for the state-trait anxiety inventory. Consulting Psychologists Press, Palo Alto, CA1970
- Anxiety and growth disturbance.J Clin Psychiatry. 1994; 55: 17-27
- Normal urinary free cortisol and postdexamethasone cortisol in social phobia.J Affect Dis. 1994; 30: 155-161
- Evidence for two subtupes of Cushing’s disease based on the analysis of episodic cortisol secretion.N Engl J Med. 1985; 312: 1343-1346
- Measurement of social-evaluative anxiety.J Consult Clin Psychol. 1969; 33: 448-457
- Sensitization of the hypothalamic-pituitary-adrenal axis in posttraumatic stress disorder.Ann N Y Acad Sci. 1997; 821: 57-75
Accepted: December 6, 2000
Received in revised form: November 20, 2000
Received: May 17, 2000
© 2001 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.