Stress reactivity in social anxiety disorder with and without comorbid depression

Previous research on neuroendocrine responding to a psychological stressor in individuals with Social Anxiety Disorder (SAD) has provided inconsistent results. A recent meta-analysis concluded that Major Depressive Disorder (MDD), which is frequently comorbid with SAD, is associated with blunted stress reactivity. It is, thus, possible that comorbidity status contributes to the inconsistent findings in the SAD literature. In this study, salivary cortisol responses to a psychological stressor were examined in three groups: healthy controls (CTL), SAD, and SAD with comorbid MDD (COM). The SAD group differed from the other two groups in their cortisol stress reactivity. It is important to note that analyses combining participants with SAD with and without comorbid MDD obscured findings of cortisol reactivity. In addition, the differences in cortisol reactivity cannot be accounted for by participants' affective responses to the stressor. The current findings indicate that individuals with SAD exhibit distinct stress-related cortisol responses depending on their comorbidity statuses.