Menstrually related mood disorders and a history of abuse:moderators of pain sensitivity.

Objective. Women with menstrually related mood disorders (MRMD) have substantial rates of physical and sexual abuse, are more sensitive to experimental pain stimuli than women without MRMD, and endorse increased sensitivity to interpersonal rejection (emotional pain) in the premenstrual phase. For the first time, this study examined physical and emotional pain sensitivity in women with MRMD and in non-MRMD controls as a function of abuse history. Methods. A total of 126 women (63 MRMD, 34 with an abuse history and 63 non-MRMD, 31 with an abuse history) were evaluated for: (1) sensitivity to cold pressor and forearm ischemic pain; (2) emotional pain sensitivity based on daily prospective ratings of sensitivity to interpersonal rejection; and (3) basal plasma cortisol and norepinephrine (NE) concentrations. Exploratory analyses examined relationships between plasma cortisol and NE concentrations and physical pain sensitivity. Results. Women with MRMD and an abuse history showed increased sensitivity to both cold pressor and ischemic pain and lower basal cortisol concentrations, an effect not seen in the non-MRMD women. However, non-MRMD women with an abuse history showed increased sensitivity to emotional pain relative to non-MRMD women with no such history. In all subjects, the expected relationship between greater plasma cortisol concentration and reduced sensitivity to physical pain was observed. While only in women with MRMD, plasma NE predicted pain sensitivity. Conclusions. MRMD status moderates the effect of a history of abuse on both physical and emotional pain sensitivity. The results also suggest that the hypocortisolemia documented in the women with MRMD and an abuse history may contribute to their greater sensitivity to noxious experimental stimuli. This study adds to a growing body of evidence suggesting that a history of abuse may identify a clinically distinct subgroup of women with MRMD

Neurosteroids in the context of stress: Implications for depressive disorders

Animal models indicate that the neuroactive steroids 3α,5α-THP (allopregnanolone) and 3α,5α-THDOC (allotetrahydroDOC) are stress responsive, serving as homeostatic mechanisms in restoring normal GABAergic and hypothalamic-pituitary-adrenal (HPA) function following stress. While neurosteroid increases to stress are adaptive in the short term, animal models of chronic stress and depression find lower brain and plasma neurosteroid concentrations and alterations in neurosteroid responses to acute stressors. It has been suggested that disruption in this homeostatic mechanism may play a pathogenic role in some psychiatric disorders related to stress. In humans, neurosteroid depletion is consistently documented in patients with current depression and may reflect their greater chronic stress. Women with the depressive disorder, premenstrual dysphoric disorder (PMDD), have greater daily stress and a greater rate of traumatic stress. While results on baseline concentrations of neuroactive steroids in PMDD are mixed, PMDD women have diminished functional sensitivity of GABAA receptors and our laboratory has found blunted allopregnanolone responses to mental stress relative to non-PMDD controls. Similarly, euthymic women with histories of clinical depression, which may represent a large proportion of PMDD women, show more severe dysphoric mood symptoms and blunted allopregnanolone responses to stress versus never-depressed women. It is suggested that failure to mount an appropriate allopregnanolone response to stress may reflect the price of repeated biological adaptations to the increased life stress that is well documented in depressive disorders and altered allopregnanolone stress responsivity may also contribute to the dysregulation seen in HPA axis function in depression

A Biopsychosocial Conceptual Framework of Postpartum Depression Risk in Immigrant and U.S.-born Latina Mothers in the United States

In this review, we offer a conceptual framework that identifies risk factors of postpartum depression (PPD) in immigrant and U.S.-born Latinas in the U.S. by focusing on psychosocial and neuroendocrine factors. While the evidence of the impact psychosocial stressors have on the development of PPD have been well documented, less is known about the biological etiology of PPD or how these complex stressors jointly increase the risk of PPD in immigrant and U.S.-born Latinas in the U.S

Neurosteroid, GABAergic and hypothalamic pituitary adrenal (HPA) axis regulation: what is the current state of knowledge in humans?

A robust epidemiological literature suggests an association between chronic stress and the development of affective disorders. However, the precise biological underpinnings of this relationship remain elusive. Central to the human response and adaptation to stress, activation and inhibition of the hypothalamic pituitary adrenal (HPA) axis involves a multi-level, multi-system, neurobiological stress response which is as comprehensive in its complexity as it is precarious. Dysregulation in this complex system has implications for human stress related illness

Mechanisms underlying hemodynamic and neuroendocrine stress reactivity at different phases of the menstrual cycle

This study examined the association of menstrual cycle phase with stress reactivity as well as the hormonal and neuroendocrine mechanisms contributing to cycle effects. Fifty-seven women underwent a modified Trier Social Stress Test during the early follicular, late follicular, and luteal phases of the menstrual cycle. Greater increases in cardiac index (CI) and greater decreases in vascular resistance index (VRI) during speech were observed in the luteal phase relative to other phases, while greater increases in epinephrine (EPI) was observed during the late follicular and luteal phases compared to the early follicular phase. Luteal phase estradiol predicted luteal EPI reactivity but not CI or VRI reactivity, while luteal phase EPI reactivity predicted luteal phase CI and VRI reactivity. Thus, cycle-related changes in EPI reactivity may be a stronger determinant of cycle effects on hemodynamic reactivity than sex hormones per se

Hypothalamic-Pituitary-Thyroid Axis Function in Women With a Menstrually Related Mood Disorder: Association With Histories of Sexual Abuse

We previously reported a unique hypothalamic-pituitary-thyroid (HPT) axis profile in women with a menstrually related mood disorder (MRMD) who also had a history of sexual abuse (SA). In the present study, we sought to extend that work by examining the association of a SA history with HPT-axis disturbance in both MRMD and non-MRMD women

The Role of Chronic Psychosocial Stress in Explaining Racial Differences in Stress Reactivity and Pain Sensitivity

To examine the role of psychosocial factors in mediating the relationship between African American (AA) race and both increased pain sensitivity and blunted stress reactivity

Menstrual cycle phase does not influence gender differences in experimental pain sensitivity

Influence of menstrual cycle phase on experimental pain sensitivity in women and on gender differences in pain sensitivity was examined in 48 men and 49 women in response to cold pressor, heat, and ischemic pain. Each woman was tested at three points in their menstrual cycle in randomized order, the early follicular, late follicular, and luteal phases, while men were also tested three times, controlling for number of days between test sessions. Cycle phase was confirmed via serum hormone levels. As expected, women were significantly more sensitive to cold pain (p < .01), to heat pain (p < .0001), and to ischemic pain (p < .01) than men. However, pain perception during each task was not influenced by the menstrual cycle in women, nor did the menstrual cycle influence the magnitude of the gender differences in pain sensitivity. These results indicate that although women are more sensitive to a variety of noxious stimuli than men, menstrual cycle phase does not appear to moderate those differences in healthy men and women

Estradiol variability, stressful life events, and the emergence of depressive symptomatology during the menopausal transition

To examine the role of estradiol fluctuation in triggering depressive symptoms in the menopause transition and assess the role of recent very stressful life events (VSLEs) as a moderating factor in this relationship

Does Self-Compassion Protect Adolescents from Stress?

The aim of this study was to determine whether adolescents who were high in self-compassion self-reported different levels of emotional wellbeing than adolescents who were low in self-compassion, and to determine whether those high in self-compassion responded differently under a lab social stressor than those low in self-compassion. In a lab setting, participants (age 13–18; n = 28) completed the Trier Social Stress Test (TSST) and physiological stress was assessed via salivary cortisol, heart rate, blood pressure, and heart rate variability at baseline, during the TSST, and during recovery. After completing the lab protocol, an email was sent to participants that provided a link to an online survey which was composed of emotional wellbeing measures including perceived stress, life satisfaction, positive and negative affect. After conducting repeated measure ANOVAS to determine that the TSST induced a significant stress response, the sample was split at the median of self-compassion. T tests were conducted to determine meaningful differences (Hedges’ g > .20) between the groups. Findings indicated that those in the high self-compassion group (≥the median) self-reported greater emotional wellbeing than those in the low self-compassion group (<the median). Overall, those in the high self-compassion group also had a lower physiologic stress response when exposed to the TSST than those in the low self-compassion group. Regression analyses were also conducted; baseline self-compassion predicted self-reported emotional wellbeing, but did not predict physiological response to the TSST. Findings support the potential buffering effect that self-compassion may have in protecting adolescents from social stressors; yet more research needs to be conducted in larger samples to confirm and replicate these findings