Extraversion modulates cortisol responses to acute social stress in chronic major depression

•Chronic Major Depressive Disorder (CMDD) is a common, disabling illness often excluded from biological research.•We used an RDoC approach linking cortisol social stress responses to dimensional personality factors in CMDD.•Higher extraversion predicted less cortisol reactivity to social stress in C...

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Published in:Psychoneuroendocrinology 2019-05, Vol.103, p.316-323
Main Authors: Chopra, Kevin, Katz, Jasmin L., Quilty, Lena C., Matthews, Stephen, Ravindran, Arun, Levitan, Robert D.
Format: Article
Language:English
Subjects:
Adult
Anxiety - metabolism
Anxiety Disorders - metabolism
Chronic major depressive disorder (CMDD)
Cortisol
Depression - metabolism
Depression - physiopathology
Depressive Disorder, Major - metabolism
Depressive Disorder, Major - physiopathology
Extraversion
Extraversion, Psychological
Female
Humans
Hydrocortisone - analysis
Hydrocortisone - metabolism
Male
Middle Aged
Neuroticism
Neuroticism - physiology
Personality
Personality Disorders - metabolism
Personality Inventory
Psychiatric Status Rating Scales
Psychosocial stress
Saliva - chemistry
Stress, Psychological - metabolism
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Summary:•Chronic Major Depressive Disorder (CMDD) is a common, disabling illness often excluded from biological research.•We used an RDoC approach linking cortisol social stress responses to dimensional personality factors in CMDD.•Higher extraversion predicted less cortisol reactivity to social stress in CMDD patients but not in controls.•This study is the first to link extraversion to social stress responses in any depressed population.•Extraversion may prove to be an important intermediate phenotype for future research and clinical work in CMDD patients. Chronic Major Depressive Disorder (CMDD) is a common, disabling illness that is often complicated by high reactivity to social stress. To further elucidate the nature of this reactivity, the current study evaluated whether the personality dimensions of neuroticism and extraversion influenced cortisol responses to a social challenge in CMDD patients vs. controls. Fifty participants with CMDD and 58 healthy controls completed the Trier Social Stress Test (TSST) using a standard protocol. Neuroticism and extraversion were measured using the Revised NEO Personality Inventory. Hierarchical linear regressions assessed associations between independent variables neuroticism and extraversion and dependent variable cortisol area-under-the-curve increase (AUCi) in response to the TSST in the two study groups. The extraversion-by-group interaction was a significant predictor of cortisol AUCi, while no significant findings related to neuroticism were found. Simple slopes analysis revealed a significant negative association between extraversion and AUCi in the CMDD group, but not in healthy controls. Post-hoc analysis of the raw cortisol data over time found that CMDD participants with higher extraversion scores had significantly higher pre-challenge cortisol levels than did other study participants, however this did not explain or confound the AUCi results. In participants with CMDD but not in controls, higher levels of extraversion were associated with higher pre-challenge cortisol levels and decreased cortisol reactivity during the TSST, however these two findings were statistically independent. These findings underline the importance of considering personality factors when studying stress biology in CMDD patients. Extraversion may prove to be an important intermediate target for both research and clinical work in this complex, heterogenous and often treatment-resistant population.
ISSN:0306-4530
1873-3360
DOI:10.1016/j.psyneuen.2019.02.008