Cortisol reactivity and suicidal behavior: Investigating the role of hypothalamic-pituitary-adrenal axis responses to stress in suicide attempters and ideators. (January 2017)

• Record Type: Journal Article
• Authors: O'Connor, Daryl B.; Green, Jessica A.; Ferguson, Eamonn; O'Carroll, Ronan E.; O'Connor, Rory C.
• Is Part Of: Psychoneuroendocrinology. Volume 75(2017)
• Page Start: 183
• Page End: 191
• Publication Date: 2017-01
• Subjects: Cortisol reactivity -- Chronic stress -- HPA axis -- Self-harm -- Allostatic load; Psychoneuroendocrinology -- Periodicals; Endocrinology -- Periodicals; Neurology -- Periodicals; Psychiatry -- Periodicals; Neuropsychoendocrinologie -- Périodiques; 616.8
• DOI: 10.1016/j.psyneuen.2016.10.019
• Languages: English
• ISSNs: 0306-4530

Abstract

Highlights: Participants who had made a previous suicide attempt exhibited significantly lower cortisol response to acute stress. Participants who made an attempt within the past year exhibited a blunted cortisol response to stress. Participants who had made a suicide attempt and had a family history of suicide also exhibited a blunted cortisol response. Lower levels of cortisol in response to stress were associated with higher suicidal ideation at 1-month in attempter group. Abstract: Every 40 s a person dies by suicide somewhere in the world. The causes of suicidal behavior are not fully understood. Dysregulated hypothalamic-pituitary-adrenal (HPA) axis activity, as measured by cortisol levels, is one potential risk factor. The current study aimed to investigate whether cortisol reactivity to a laboratory stress task differentiated individuals who had previously made a suicide attempt from those who had thought about suicide (suicide ideators) and control participants. One hundred and sixty participants were recruited to a previous attempt, a suicidal ideation or a control group. Participants completed background questionnaires before completing the Maastricht Acute Stress Test (MAST). Cortisol levels were assessed throughout the stress task. Measures of suicide behavior were measured at baseline, 1 month and 6 month follow-up. Participants who had made a previous suicide attempt exhibited significantly lower aggregate cortisol levels during the MAST compared to participants in the control group; suicide ideators were intermediate to both groups. This effect, however, was driven by participants who made an attempt within the past year, and to some degree by those with a family history of attempt. Participants who made a suicide attempt and had a family history of suicide exhibited the lowest levels of cortisol in response to stress. Finally, lower levels of cortisol in response to the MAST were associated with higher levels of suicidal ideation at 1-month follow-up in the suicide attempter group. These results are consistent with other findings indicating that blunted HPA axis activity is associated with some forms of suicidal behavior. The challenge for researchers is to elucidate the precise causal mechanisms linking stress, cortisol and suicide risk.