Lower cortisol levels and attenuated cortisol reactivity to daily-life stressors in adults with 22q11.2 deletion syndrome

Abstract

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Affective and psychotic reactivity to daily-life stress in adults with 22q11DS: a study using the experience sampling method

“…In particular, this result was mainly driven by the fact that participants with 22q11DS often reported the presence of extremely unpleasant events, whereas HCs mainly reported the presence of minimally unpleasant events in the flow of daily life. Interestingly, two recent studies reported reduced exposure to stressful life events [23], as measured with the Coddington Life Event Scale (CLES), and comparable exposure to traumatic events [28], as measured with the Childhood Trauma Questionnaire (CTQ), in individuals with 22q11DS compared to HCs, which might appear in contradiction with the present findings. However, whereas the CLES or CTQ target discrete life events that happen at a relatively low frequency (e.g., changing school/work or being the victim of violence), the current study might rather reflect an increased prevalence of minor events that are subjectively experienced as stressful by individuals with 22q11DS, such as ongoing daily hassles (i.e., demands or conditions of daily living that have been appraised as salient and harmful or threatening to the endorser's wellbeing; [37]).…”

“…Indeed, previous studies have shown that adults with 22q11DS are characterized by a reduced volume of the pituitary gland, low mean salivary cortisol, and a blunted cortisol reactivity to stress compared to HCs [23,28], whereas increased salivary cortisol and a similar volume of the pituitary gland than HCs were reported in younger individuals [23,43,44]. As suggested by van Duin et al [28], differences across age groups might be explained by chronic overactivation of the HPA-axis, eventually resulting in an "exhaustion" of the cortisol response to stress, similar to what has been described in posttraumatic stress disorder (PTSD) (e.g., [45]). Following this hypothesis, one could expect increased affective and psychotic reactivity to daily-life stress in children and adolescents with 22q11DS that then decreases by the time individuals reach adulthood.…”

“…The results obtained in the 22q11DS sample were compared to those obtained in a sample of 24 HCs. Recruitment and inclusion criteria for the 22q11DS and HC subjects are as described previously [27,28]. The participants included in the present study are overlapping with those included in van Duin et al [28].…”

“…Second, although ESM has been validated in multiple studies, to our knowledge it has rarely been used in the 22q11DS population (but see [28]) and more generally in individuals with neurodevelopmental disorders (but see [46]). Even if the number of participants who had to be excluded from the final analyses (because they answered to less than a third of the emitted beeps) was acceptable, the total number of completed beeps was lower in the 22q11DS group but was not significantly associated with IQ.…”

Cortisol Responses to Naturally Occurring Psychosocial Stressors Across the Psychosis Spectrum: A Systematic Review and Meta-Analysis

“…Both of these studies used the ESM approach to obtain cortisol samples within 10 min of stressor ratings (53,60); however, even with this short lapse-of-time, significant associations between event stress and salivary cortisol were not observed in healthy controls, only those on the psychosis spectrum (i.e., relatives and patients with psychotic disorders). Interestingly, a recent ESM study examining individuals with 22q11.2 deletion syndrome (a syndrome associated with learning difficulties, a range of physical health problems, and psychiatric comorbidity-including psychosis), reported that cortisol levels in the healthy control group, but not the 22q11.2 deletion syndrome group, increased in parallel with activity related stress, but that this association in controls was only significant at the trend level (80). Together, these findings suggest that the activity-/event-related stress captured using existing ESM approaches may not be sufficiently "stressful" to elicit robust changes in cortisol levels in healthy controls.…”