Stress, depressive symptoms, interpersonal relatedness, and HPA axis functioning in women.

Depression is a critical health issue, occurring twice as often in women as men. Interpersonal factors and HPA axis dysregulation have been associated with both stress and depression. Two studies are reported examining associations among perceived stress, depressive symptoms, interpersonal relatedness, and HPA axis functioning in women. In the first study, regression analysis on data from 301 female nursing students indicated sense of belonging accounted for the greatest variance in both perceived stress and depressive symptoms. Based on self-reported scores from the Beck Depression Inventory (BDI) and Perceived Stress Scale (PSS), data from 166 subjects met criteria to fit into one of three groups representing women experiencing varying levels of perceived stress and depressive symptoms. ANOVA revealed significant differences among the groups with respect to interpersonal relatedness measured by the concepts of attachment style, reciprocity, social support, conflict, and sense of belonging. Those women having higher levels of secure attachment, reciprocity, social support, and sense of belonging had significantly lower levels of perceived stress and depressive symptoms. The second study employed the Trier Social Stress Test (TSST), a psychosocial stress paradigm, to stimulate an HPA axis response in 28 female nursing students. Individual scores on the BDI and PSS again determined group membership. Cortisol response patterns were produced from repeated salivary samples collected every five minutes before, during, and for one hour after the 15-minute TSST. The three a priori groups differing in levels of stress and depressive symptoms did not exhibit differences in their cortisol response patterns to the induced psychosocial stress. However, upon visual inspection, five cortisol response patterns did emerge. The patterns generated were significantly different from each other across time and on the cortisol parameters of delta and area under the curve. Sense of belonging and insecure attachment were significantly different among women in three of the five cortisol response pattern groups. While it is not exactly clear what these different cortisol patterns represent, the data is interpreted in the context of interpersonal relatedness with recommendations for nursing practice and future research.Ph.D.Health and Environmental SciencesMental healthNursingPhysiological psychologyPsychologySocial SciencesWomen's studiesUniversity of Michigan, Horace H. Rackham School of Graduate Studieshttp://deepblue.lib.umich.edu/bitstream/2027.42/131857/2/9938406.pd