Cortisol como variável em psicologia da saúde

António José de Almeida Soares& Maria da Graça Pereira Alves ^*

Universidade do Minho, Departamento de Psicologia, Braga, Portugal

 

Resumo: O artigo faz uma pequena revisão sobre a investigação passada e recente no campo do Stress. É dada particular atenção às alterações fisiológicas decorrentes das situações de stress e distress, principalmente em cuidadores informais de pacientes com doença crónica. São referidos métodos de avaliação das hormonas de stress, bem como dos seus benefícios, limitações e implicações na saúde física e mental. Por fim, são feitas considerações acerca da importância do cortisol como método válido de estudo em Psicologia da Saúde.

Palavras chave: Ansiedade, Cortisol, Cuidador, Depressão, Doença crónica, PTSD, Saúde, Stress.

 

Cortisol as a variable in health psychology

Abstract: The article revises past and recent research in Stress. Special relevance is given to the physiological changes that occur due to stress and distress situations, mainly in informal caregivers of chronically ill patients. Some methods of assessment of stress hormones are reviewed, along with their benefits, limitations and implications to physical and mental health. Finally, the importance of the use of cortisol as a valid method of study in Health Psychology is emphasized.

Key words: Anxiety, Caregiver, Cortisol, Chronic disease, Depression, Health, PTSD, Stress.

 

 

Texto completo disponível apenas em PDF.

Full text only available in PDF format.

 

 

Referências

Anisman, H., & Zacharko, R. M. (1992). Depression as a consequence of inadequate neurochemical adptation in response to stressors. British Journal of Psychiatry, 160, 36-43.

        [ Links ]

Adam, E.K., & Gunnar, M.R. (2001). Relationship functioning and home and work demands predict individual differences in diurnal cortisol patterns in women. Psychoneuroendocrinology, 26, 189-208.

Bassett, J.R., Marshall, P.M., & Spilane, R. (1987). The psychological measurement of acute stress (public speaking) in bank employees. Psychophysiology, 5, 265-273.

Baron, R.S., Cutrona, C., Hicklin, D., Russel, D., & Lubaroff, D. (1990). Social support and immune function among spouses of cancer patients. Journal of Personality and Social Psychology, 59, 344-352

Bauer, M.E., Vedhara, K., Perks, P., Wilcock, G.K., Lightman, S.L., & Shanks, N. (2000). Chronic stress in caregivers of dementia patients is associated with reduced lymphocyte sensitivity to glucocorticoids. Journal of Neuroimmunology, 103(1), 84-92.

Bremner, D., Vythilingam, M., Anderson, G., Vermetten, E., McGlashan, T., Heninger, G., Rasmusson, A., Southwick, S., & Charney, D. (2003). “Assessment of the hypothalamic-pituitaryadrenal axis over 24-hour diurnal period and in response to neuroendocrine challenges in women with and without childhood sexual abuse and posttraumatic stress disorder. Biological Psychiatry, 54(7), 710-718.

Bremner, D., Vythilingam, M., Vermetten, E., Adil, J., Khan, S., Nazeer, A., Afzal, N., McGlashan, T., Elzinga, B., Anderson, G., Heninger, G., Southwick, S., & Charney, D. (2003). Cortisol response to a cognitive stress challenge in posttraumatic stress disorder (PTSD) related to childhood abuse. Psychoneuroendocrinology, 28(6), 733-750.

Brocklehurst, J.C., Morris, P., Andrews, K., & Laycock, P. (1981). Social effects of stroke. Social Science and Medicine, 15, 35-39.

Cannon, W.B. (1932). The wisdom of the body. New York: W.W. Norton.

Cohen, S., Kessler, R.C., & Gordon, L.U. (1997). Measuring Stress – A Guide for Health and Social Scientists. New York: Oxford University Press.

Cohen, S., & Williamson, G.M. (1991). Stress, social support and the buffering hypothesis. Psychological Bulletin, 98, 310-357.

Conway, T.L., Vickers, R., Ward, H., & Rahe, R. (1981). Occupational stress and variation in cigarette, coffee and alcohol consumption. Journal of Health & Social Behavior, 22, 155-165.

Chrousos, G.P., & Gold, P.S. (1992). The concepts of stress and stress systems disorders: overview of physical and behavioral homeostasis. The Journal of the America Medical Association, 267(9), 1244-1252

Dougall, A.L. (2001). Stress, Health, and Illness. In A. Baum, T. Revenson, & J. Singer (Eds.), Handbook of Health Psychology (pp. 321-336). London: Lawrence Erlbaum Associates.

Elzinga, B., Schmahl, C., Vermetten, E., van Dyck, R., & Bremner, D. (2003). Higher cortisol levels following exposure to traumatic reminders in abuse-related PTSD. Neuropsychopharmacology, 28(9), 1656-1665.

Fukuzuka, K., Edwards, C., Clare-Salzer, M., Copeland, E., Moldawer, L., & Mozingo, D. (2000). Glucocorticoid-induced, caspase-dependent organ apoptosis early after burn injury. American Journal Physiology. Regulatory,integrative and comparative physiology, 278(4), 1005-1018.

Goldman, L.S., & Luchins, D.J. (1984). Depression in spouses of demented patients. American Journal of Psychiatry, 14, 1467-1468.

Glaser, R., et al. (1992). Stress induced modulation of the immune response to recombinant hepatitis B vaccine. Psychosomatic Medicine, 54, 22-29

Glover, D.A., & Poland, R.E. (2002). Urinary cortisol and catecholamines in mothers of chil cancer survivors with and without PTSD. Psychoneuroendocrinology, 27, 805-819.

Hawk, L.W., Dougall, A.L., Ursano, R.J., & Baum, A. (2000). Urinary catecholamines and cortisol in recent-oncet posttraumatic stress disorder after motor vehicle accidents. Psychosomatic Medicine, 62, 423-434.

Hennig, J., Netter, P., & Voigt, K.(2001). Cortisol mediates redistribution of CD8+ but not of CD56+ cells after the psychological stress of public speaking. Psychoneuroendocrinology, 26(7), 673-687.

Herd, J.A. (1986). Neuroendocrine mechanisms in coronary heart disease. In K.A. Matthews et al. (Eds.), Handbook of stress, reactivity and cardiovascular disease (pp. 49-70). New York: Wiley.

Hoffman-Goetz, L., & Zajchowski, S. (1999). In vitro apoptosis of lymphocytes after exposure to levels of corticosterone observed following submaximal exercise. Journal of Sports, Medicine, Physiology and Fitness, 39(4), 269.

Irwin, M. (1999). Immune correlates of depression. Advances in Experimental Medicine and Biology, 461, 1-24

Kiecolt-Glaser, J., et al. (1987). Chronic stress and immune function in family caregivers of Alzheimer’s disease victims. Psychosomatic Medicine, 45(5), 523.

Lehnert, H., Beyer, J., Walger, P., et al. (1989). Salivary cortisol in normal men. In Weiner, I. Florin, & D.H. Hellhmmer (Eds.), Frontiers in stress research (pp. 392-394). Toronto: Huber.

Lemieux, A.M., & Coe, C.L. (1995). Abuse-related posttraumatic stress disorder: Evidence for chronic neuroendocrine activation in women. Psychosomatic Medicine, 57, 105-115.

Levi, L. (Ed.). (1972). Stress and distress in response to psychosocial stimuli. New York: Pergamon Press.

Lezak, M.D. (1978). Living with the caracteriologically altered brain injured patient. Journal of Clinical Psychiatry, 38, 592-598.

Kirschbaum, C., & Hellhammer, D.H. (1989). Salivary cortisol in psychobiological research: An overview. Neuropsychobiology, 22, 150-169.

Maes, M., Lin, A., Bonaccorso, S., Van Hunsel, F., Van Gastel, A., et al. (1998). Increased 24-hour urinary cortisol excretion in patients with posttraumatic stress disorder and patients with major depression, but not in patients with fibromyalgia. Acta Psychiatrica Scandinavica, 998, 328-335.

Matthews, K.A., Weiss, S., Detre, T., Dembroski, Falkner, B., Manuck, S., & Wiliams, R. (Eds.). (1986). Handbook of stress, reactivity and cardiovascular disease. New York: Wiley.

McCubbin, J.A., Richardson, J., Obrist, P.A., Kizer, J.S., & Langer, A.W. (1980). Cathecholaminergic and hemodynamic responses to behavioral stress in young adult males. Paper presented ant the 20^th Annual Meeting of the Society for Psychophysiological Research.

McEwen, B.S. (1998). Protective and damaging effects of stress mediators. New England Journal of Medicine, 338, 171-179.

Pitman, R.K., & Orr, S. (1990). Twenty-four hour urinary cortisol and catecholamine excretion in combat-related PTSD. Biological Psychiatry, 27, 245-247.

Poehlmann, K.M. (1998). “The effects of psychological stress on cardiovascular and neuroendocrine reactivity”. Dissertation Abstracts International: Section B: The Sciences & Engineering, 59(8-B), 4541.

Polk, D., Cohen, S., Doyle, W., Skoner, D. & Kirschbaum, C. (2005). State and trait affect as predictors of salivary cortisol in healthy adults. Psychoneuroendocrinology, 30, 261-272.

Pearlin, L., Mullan, J., Semple, S., & Skaff, M. (1990). Caregiving and the stress process: An overview of concepts and their measure. The Gerontologist, 30(5), 583-594.

Rabin, B.S. (1999). Stress, immune function and health: The connection. New York: Wiley-Liss.

Rabin, B.S., Cohen, S., Ganguli, R., Lysle, D.T., & Cunnick, J.E. (1989). Bidirectional interaction between the central nervous system and the immune system. CRC Critical Reviews in Immunology, 9, 279-312.

Raveis, V.H., Karus, D., & Pretter, S. (1999). “Correlates of anxiety among adult daughter caregivers to a parent with cancer”. Journal of Psychosocial Oncology, 17(3-4), 1-26.

Rozlov, L.A., et al. (1999). Stress and immunity: Implications for viral disease and wound healing. Journal of Periodontology, 70(7), 786.

Sapolsky, R.M., Romero, L.M., & Munk, A.U. (2000). How do glucocorticoids influence stress responses? Integrating permissive, supressive, stimulatory and preparative actions. Endocrinological Review, 21(1), 55.

Selye, H. (1974). Stress without distress. Philadelphia: J.B. Lippincott.

Sephaton, S.E., Sapolsky, R.M., Kraemer, H.C., & Spiegel, D. (2000). Diurnal cortisol rythim as a predictor of breast cancer survival. Journal of the National Cancer Institute, 92, 994-1000.

Sheehan, N.W., & Nuttal, P. (1988). Conflict, emotion and personal strain among family caregivers. Family Relations, 37(1), 92-98.

Shelby, J., & Kathryn, L. (2001). Stress and Disease. In S. Huether & K. McCance (Eds.), Pathophysiology: The biologic basis for disease in adults and children (4th ed., pp. 272-289). St. Louis: C.V. Mosby.

Sousa, C. (2005). Representações da doença, ajustamento à doença, morbilidade psicológica, qualidade de vida e satisfação marital em doentes com esclerose múltipla e seus cuidadores. Universidade do Minho, Braga.

Stahl, F., & Dorner, G. (1982). Responses of salivary cortisol levels to situations. Endocrinology, 80, 150-162.

Steptoe, A., Kunz-Ebrecht, S., Owen, N., Feldman, P.J., Willemsen, G., Kirschbaum, C., & Mamot, M. (2003). Socio-economical status and stress-related biological responses over the working day. Psychosomatic Medicine, 65, 461-470.

Vedhara, K., McDermott, M.P., Evans, T.G., Treanor, J.J., Plummer, S., Tallon, D., Cruttenden, K.A., & Schiffitto, G. (2002). Chronic stress in non elderly caregivers: Psychological, endocrine and immune implications. Journal of Psychosomatic Research, 53(6), 1153-1161.

Vedhara, K., Shanks, N., Anderson, S., & Lightman, S. (2000). The role of stressors and psychosocial variables in the stress process: A study of chronic caregiver stress. Psychosomatic Medicine, 62(3), 374-385.

Vining, R.F., & McGinley, R.A. (1984). Transport of steroid from bood to saliva. In G.F. Read, D. Riad-Fahmy, & R.F. Walker (Eds.), Radioimmunoassays of steroids in saliva (pp. 56-63). Cardiff: Alpha Omega.

Von Känel, R., Dimsdale, J.E., Patterson, T.L., & Grant, I. (2003). “Association of negative life event stress with coagulation activity in elderly Alzheimer caregivers”. Psychosomatic Medicine, 65(1), 145-150.

Wust, S., Wolf, J. Hellhammer, D.H., Federenko, I., Schommer, N., & Kirschbaum, C. (2000). The cortisol awakening response – Normal values and confounds. Noise and Health, 7, 77-85.

Yehuda, R., Kahana, B., Binder-Byrnes, K., et al. (1995). Low urinary cortisol excretion in holocaust survivors with PTSD. American Journal of Psychiatry, 152, 7-12.

Yehuda, R., & McFarlane, A.C. (1997). Psychobiology of posttraumatic stress disorder. New York: New York Academy of Sciences.

Yehuda, R. (2000). Biology of posttraumatic stress disorder. Journal of Clinical Psychiatry, 61(7), 14-21.

Yehuda, R. (2002). Posttraumatic stress disorder. New England Journal of Medicine, 346(2), 108-114.

 

^* Contactar para E-mail: gracep@iep.uminho.pt

Recebido em 18 de Janeiro de 2006 / aceite em 7 de Maio de 2006