Regulation of hypothalamic-pituitary-adrenal activity in response to cognitive therapy in patients with generalized anxiety disorder

The aim of this study was to evaluate the efficacy of cognitive therapy (CT) in the treatment of generalized anxiety disorder (GAD), as it would be reflected through both psychological and psychoneuroendocrinological parameters. For this purpose, a group of outpatients with GAD were treated with CT for up to a maximum of 24 sessions. In order to assess psychological and biological changes, anxiety-related symptoms were evaluated according to the Hamilton Anxiety Rating Scale (HAM-A), and the hypothalamic-pituitary-adrenal (HPA) function was determined through assessment of circulating cortisol levels. A significant decrease in the HAM-A scores, along with significant changes in plasma cortisol levels, were observed after completion of treatment with CT. These observations contribute to demonstrate that the effect of certain psychotherapeutic approaches, such as CT, may be observed at both psychological and biological levels.     

Correlation between cortisol level and serotonin uptake in patients with chronic stress and depression

In a recent study (Tafet, Toister-Achituv, & Shinitzky, 2001), we demonstrated that cortisol induces an increase in the expression of the gene coding for the serotonin transporter, associated with a subsequent elevation in the uptake of serotonin. This stimulatory effect, produced upon incubation with cortisol in vitro, was observed in peripheral blood lymphocytes from normal subjects. In the present work we investigated the cortisol-induced increase in serotonin uptake in lymphocytes from hypercortisolemic patients, including subjects with major depressive disorder (n = 8), and subjects with generalized anxiety disorder (n = 12), in comparison with a control group of normal healthy subjects (n = 8). A significant increase in serotonin uptake (+37%+14, M + SD) was observed in the control group, whereas neither the generalized anxiety disorder nor the major depression group exhibited changes in serotonin uptake upon incubation with cortisol. It is likely that under chronic stress or depression, the capacity for increase in serotonin transporter has reached its limit due to the chronically elevated blood cortisol level. The physiological and diagnostic implications of this observation are discussed.     

Embedding sensation seeking within the big three

While Sensation Seeking is a construct which loads on both Extraversion (E) and Psychoticism (P), it is not clear whether Sensation Seeking can be reduced to E and P and whether all of its subfactors necessarily load on the same factor(s). We therefore decided to investigate the relationship among these. The 682 participants comprised a heterogeneous sample. They completed the SSS (Form V) and then the EPQ-R-S (short version of the revised EPQ). Factor analysis of the EPQ-R-S revealed simple structure, with 46 of the 48 items being correctly located on their respective factors. Analysis of the SSS also revealed simple structure, with 31 of the 40 items being correctly located on their respective factors. When the items from the EPQ-R-S and SSS were combined in one analysis, using a 4-factor constraint, we could identify these as follows: The first factor entailing items from 3 SSS scales (ES, Dis and BS) and 2 EPQ scales (L and P), could be referred to as Impulsive Unsocialized Sensation Seeking (P-ImpUSS). The second was identified as N; the third was identified as E; and the fourth as TAS. Thus it is P which loads on P-ImpUSS, with TAS being distinct from the latter.     

Acquired Capability for Suicide,Pain Tolerance,and Fearlessness of Pain—Validation of the Pain Tolerance Scale of the German Capability for Suicide Questionnaire

The interpersonal theory of suicide (Joiner, 2005) postulates that for a serious suicide attempt, one has to possess the acquired capability to commit suicide. Acquired capability includes higher pain tolerance, which is further assumed to comprise both an elevated physical pain tolerance and fearlessness of pain. Recently, the German Capability for Suicide Questionnaire (GCSQ) was validated. The aim of this study is further validation of the GCSQ's Pain Tolerance scale by investigating the scale's association with objective pain tolerance and fearlessness of pain in two undergraduate samples (N = 81; N = 76). Both associations were found indicating a strong criterion validity of the Pain Tolerance scale.