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

Gregory E. Miller*, Edith Chen, Eric S. Zhou

*Corresponding author for this work

Research output: Contribution to journalReview article

1381 Scopus citations

Abstract

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 by a person's response to the situation; it increases with subjective distress but is lower in persons with posttraumatic stress disorder.

Original languageEnglish (US)
Pages (from-to)25-45
Number of pages21
JournalPsychological Bulletin
Volume133
Issue number1
DOIs
StatePublished - Jan 1 2007

Keywords

  • Cortisol
  • HPA axis
  • Stress
  • Trauma

ASJC Scopus subject areas

  • Psychology(all)

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