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

The notion that chronic stress fosters disease by activating the hypothalamic-pituitary-adrenocortical (HPA) axis is featured prominently in many theories. The research linking chronic stress and HPA function is contradictory, however, with some studies reporting increased activation, and others reporting the opposite. This meta-analysis showed that much of the variability is attributable to stressor and person features. Timing is an especially critical element, as hormonal activity is elevated at stressor onset but reduces as time passes. Stressors that threaten physical integrity, involve trauma, and are uncontrollable elicit a high, flat diurnal profile of cortisol secretion. Finally, HPA activity is shaped…

• NA
  National Alliance for Research on Schizophrenia and Depression
• MS
  Michael Smith Health Research BC
• CI
  Canadian Institutes of Health Research
• NH
  National Heart, Lung, and Blood Institute