Depression and anxiety predict sex-specific cortisol responses to interpersonal stress.

Clinical theories posit interpersonal stress as an important factor in the emergence and exacerbation of depression and anxiety, while neuroendocrine research confirms the association of these syndromes with dysregulation in a major stress response system, the hypothalamic-pituitary-adrenal (HPA) axis. However, the proposal that depression and anxiety symptoms and diagnoses are associated with problematic HPA responses to close relationship stress has not been directly tested. We examined 196 heterosexual dating couples' depression and anxiety symptoms and diagnoses, assessed with questionnaires and diagnostic interviews, in relation to cortisol responses to discussion of an unresolved relationship conflict. Participants provided seven salivary samples in anticipation of and directly following the discussion, and throughout an hour-long recovery period, which were assayed for cortisol. Multilevel models of the HPA response predicted by symptoms or diagnoses showed that women's depressive symptoms predicted attenuated cortisol levels, with a flatter response curve. In contrast, men's depression symptoms and women's anxiety symptoms and diagnoses predicted higher cortisol levels. These findings highlight the importance of examining sex differences in responses to interpersonal stressors for understanding HPA dysregulation in internalizing psychopathology.

HPA regulation and dating couples' behaviors during conflict: gender-specific associations and cross-partner interactions.

The way romantic partners behave during conflict is known to relate to stress responses, including activation of the hypothalamic-pituitary-adrenal (HPA) axis; however, little attention has been paid to interactive effects of partners' behaviors, or to behavior outside of marital relationships. This study examined relations between unmarried partners' negative and positive behaviors during discussion of conflict and their HPA responses, including both main effects and cross-partner interactions. Emerging adult opposite-sex couples (n=199) participated in a 15-minute conflict discussion and afterward rated their behavior on 3 dimensions: conflictual, holding back, and supportive. Seven saliva samples collected before and after the discussion were assayed for cortisol to determine HPA response. Quadratic growth models demonstrated associations between male×female partners' behaviors and cortisol trajectories. Two negative dyadic patterns-mutual conflictual behavior (negative reciprocity); female conflictual/male holding back (demand-withdraw)-and one positive pattern-mutual supportive behavior-were identified. Whereas negative patterns related to lower cortisol and impaired post-discussion recovery for women, the positive pattern related to lower cortisol and better recovery for men. Women's conflictual behavior only predicted problematic cortisol responses if their partner was highly conflictual or holding back; at lower levels of these partner behaviors, the opposite was true. This work demonstrates similar costs of negative reciprocity and demand-withdraw and benefits of supportive conflict dynamics in dating couples as found in marital research, but associations with HPA are gender-specific. Cross-partner interactions suggest that behavior during discussion of conflict should not be categorized as helpful or harmful without considering the other partner's behavior.

Differential effects of subtypes of trauma symptoms on couples' hypothalamus-pituitary-adrenal (HPA) axis reactivity and recovery in response to interpersonal stress.

This article examined the relation of five subtypes of trauma symptoms to hypothalamus-pituitary-adrenal (HPA) functioning as assessed with salivary cortisol before, during, and after an experimentally induced interpersonal conflict task in 194 heterosexual young adult couples. Trauma history and symptoms were assessed through structured clinical interviews and standardized self-report measures. Hierarchical linear modeling was used to analyze the effects of trauma symptoms on trajectories of cortisol reactivity to and recovery from the interpersonal stress. Trauma-related anxiety, depression, sleep disturbances, and dissociation significantly predicted cortisol reactivity and recovery. Trauma-related anxiety, sleep disturbances, and sexual problems significantly predicted partners' cortisol reactivity to interpersonal stress.