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If it goes up, must it come down? Chronic stress and the hypothalamic-pituitary-adrenocortical axis in humans

Gregory E Miller1, Edith Chen, Eric S Zhou

  • 1Department of Psychology, University of British Columbia (UBC), Vancouver, BC, Canada. gemiller@psych.ubc.ca

Psychological Bulletin
|January 5, 2007
PubMed

Insights

Chronic stress impacts disease by affecting the hypothalamic-pituitary-adrenocortical (HPA) axis. Variability in HPA axis research is explained by stressor type, timing, and individual responses, including distress levels.

Area of Science:

  • Psychoneuroendocrinology
  • Stress Physiology
  • Behavioral Medicine

Background:

  • The hypothalamic-pituitary-adrenocortical (HPA) axis is theorized to mediate the link between chronic stress and disease.
  • Existing research on chronic stress and HPA axis activity presents contradictory findings, with some studies showing activation and others showing inhibition.

Purpose of the Study:

  • To resolve inconsistencies in the literature regarding chronic stress and HPA axis function.
  • To identify key factors contributing to the variability in HPA axis responses to stress.

Main Methods:

  • A meta-analysis was conducted to synthesize findings from existing studies on chronic stress and HPA axis activity.
  • Statistical methods were employed to examine the influence of stressor characteristics, temporal factors, and individual differences on HPA axis outcomes.

Main Results:

  • Variability in HPA axis response is significantly explained by features of the stressor and individual characteristics.
  • Hormonal activity is elevated at stressor onset but diminishes over time.
  • Stressors involving threats to physical integrity, trauma, and uncontrollability are associated with a high, flat diurnal cortisol secretion profile.
  • Subjective distress amplifies HPA axis activity, whereas posttraumatic stress disorder is linked to reduced HPA activity.

Conclusions:

  • The relationship between chronic stress and HPA axis function is complex and modulated by multiple factors.
  • Understanding stressor type, timing, and individual psychological responses is crucial for interpreting HPA axis activity in health and disease.
  • These findings highlight the need for nuanced approaches when examining the HPA axis in stress-related disorders.

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