Post-dexamethasone Cortisol, Self-inflicted Injury, and Suicidal Ideation Among Depressed Adolescent Girls

Overview

Journal J Abnorm Child Psychol

Publisher Springer

Date 2014 Sep 12

PMID 25208812

Citations 19

Authors

Theodore P Beauchaine

Sheila E Crowell

Ray C Hsiao

Affiliations

Soon will be listed here.

Abstract

Although the dexamethasone suppression test (DST) has limited use as a biomarker of depression given inadequate sensitivity and specificity, it marks prospective risk for suicide among adults. However, few studies have examined associations between the DST, suicidal ideation, and self-inflicted injury (SII) among adolescents, even though SII is the single best predictor of eventual suicide. We evaluated the DST as a correlate of suicidal ideation and retrospective reports of self-inflicted injury (SII) among adolescent girls, ages 13-17, with histories of depression (n = 28) or depression and self-harm (n = 29). Lower post-DST cortisol was associated with suicidal ideation and SII, over-and-above parent-reports and combined parent-/self-reports of internalizing and externalizing behavior. These findings are consistent with recent acquired capacity models of stress-related psychopathology in which hypothalamic-pituitary adrenal (HPA) axis function is altered through epigenetic/allostatic mechanisms among vulnerable individuals who incur adversity early in life.

Citing Articles

Childhood trauma cortisol and immune cell glucocorticoid transcript levels are associated with increased risk for suicidality in adolescence.

Goltser-Dubner T, Benarroch F, Lavon M, Amer R, Canetti L, Giesser R Mol Psychiatry. 2025; .

PMID: 39994424 DOI: 10.1038/s41380-025-02923-3.

Epigenetics and suicidal behavior in adolescents: a critical review.

Funahashi Y, Dwivedi Y Epigenomics. 2025; 17(4):247-262.

PMID: 39819344 PMC: 11853622. DOI: 10.1080/17501911.2025.2453415.

Gender Differences of Antioxidant System and Thyroid Function in Depressed Adolescents with Non-Suicidal Self-Injury.

Zhang C, Li Y, Wang W, Jiang Z, Liu C, Kong Y Neuropsychiatr Dis Treat. 2024; 20:1309-1319.

PMID: 38933097 PMC: 11199165. DOI: 10.2147/NDT.S452643.

The quest for a biological phenotype of adolescent non-suicidal self-injury: a machine-learning approach.

Murner-Lavanchy I, Koenig J, Reichl C, Josi J, Cavelti M, Kaess M Transl Psychiatry. 2024; 14(1):56.

PMID: 38267430 PMC: 10810046. DOI: 10.1038/s41398-024-02776-4.

Molecular Changes Associated with Suicide.

Navarro D, Marin-Mayor M, Gasparyan A, Garcia-Gutierrez M, Rubio G, Manzanares J Int J Mol Sci. 2023; 24(23).

PMID: 38069051 PMC: 10706600. DOI: 10.3390/ijms242316726.

References

McGowan P, Sasaki A, DAlessio A, Dymov S, Labonte B, Szyf M . Epigenetic regulation of the glucocorticoid receptor in human brain associates with childhood abuse. Nat Neurosci. 2009; 12(3):342-8. PMC: 2944040. DOI: 10.1038/nn.2270. View

Jokinen J, Nordstrom P . HPA axis hyperactivity and attempted suicide in young adult mood disorder inpatients. J Affect Disord. 2008; 116(1-2):117-20. DOI: 10.1016/j.jad.2008.10.015. View

Kirschbaum C, Wust S, Hellhammer D . Consistent sex differences in cortisol responses to psychological stress. Psychosom Med. 1992; 54(6):648-57. DOI: 10.1097/00006842-199211000-00004. View

Cecchi M, Khoshbouei H, Javors M, Morilak D . Modulatory effects of norepinephrine in the lateral bed nucleus of the stria terminalis on behavioral and neuroendocrine responses to acute stress. Neuroscience. 2002; 112(1):13-21. DOI: 10.1016/s0306-4522(02)00062-3. View

PFEFFER C, Stokes P, Shindledecker R . Suicidal behavior and hypothalamic-pituitary-adrenocortical axis indices in child psychiatric inpatients. Biol Psychiatry. 1991; 29(9):909-17. DOI: 10.1016/0006-3223(91)90057-s. View

Beauchaine T, Neuhaus E, Zalewski M, Crowell S, Potapova N . The effects of allostatic load on neural systems subserving motivation, mood regulation, and social affiliation. Dev Psychopathol. 2011; 23(4):975-99. DOI: 10.1017/S0954579411000459. View

Gadow K, Sprafkin J, Carlson G, Schneider J, Nolan E, Mattison R . A DSM-IV-referenced, adolescent self-report rating scale. J Am Acad Child Adolesc Psychiatry. 2002; 41(6):671-9. DOI: 10.1097/00004583-200206000-00006. View

Linehan M, Comtois K, Brown M, Heard H, Wagner A . Suicide Attempt Self-Injury Interview (SASII): development, reliability, and validity of a scale to assess suicide attempts and intentional self-injury. Psychol Assess. 2006; 18(3):303-12. DOI: 10.1037/1040-3590.18.3.303. View

Crowell S, Beauchaine T, McCauley E, Smith C, Stevens A, Sylvers P . Psychological, autonomic, and serotonergic correlates of parasuicide among adolescent girls. Dev Psychopathol. 2006; 17(4):1105-27. DOI: 10.1017/s0954579405050522. View

10.

Klonsky E, May A, Glenn C . The relationship between nonsuicidal self-injury and attempted suicide: converging evidence from four samples. J Abnorm Psychol. 2012; 122(1):231-237. DOI: 10.1037/a0030278. View

11.

Kaufman J, Birmaher B, Brent D, Rao U, Flynn C, Moreci P . Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version (K-SADS-PL): initial reliability and validity data. J Am Acad Child Adolesc Psychiatry. 1997; 36(7):980-8. DOI: 10.1097/00004583-199707000-00021. View

12.

Hamza C, Stewart S, Willoughby T . Examining the link between nonsuicidal self-injury and suicidal behavior: a review of the literature and an integrated model. Clin Psychol Rev. 2012; 32(6):482-95. DOI: 10.1016/j.cpr.2012.05.003. View

13.

Young E . Sex differences and the HPA axis: implications for psychiatric disease. J Gend Specif Med. 2001; 1(1):21-7. View

14.

Arana G, Baldessarini R, Ornsteen M . The dexamethasone suppression test for diagnosis and prognosis in psychiatry. Commentary and review. Arch Gen Psychiatry. 1985; 42(12):1193-204. DOI: 10.1001/archpsyc.1985.01790350067012. View

15.

Wikgren M, Maripuu M, Karlsson T, Nordfjall K, Bergdahl J, Hultdin J . Short telomeres in depression and the general population are associated with a hypocortisolemic state. Biol Psychiatry. 2011; 71(4):294-300. DOI: 10.1016/j.biopsych.2011.09.015. View

16.

Graham J . Missing data analysis: making it work in the real world. Annu Rev Psychol. 2008; 60:549-76. DOI: 10.1146/annurev.psych.58.110405.085530. View

17.

De Los Reyes A, Kazdin A . Informant discrepancies in the assessment of childhood psychopathology: a critical review, theoretical framework, and recommendations for further study. Psychol Bull. 2005; 131(4):483-509. DOI: 10.1037/0033-2909.131.4.483. View

18.

Thomson W . Long term follow up of suicide in a clinically depressed community sample. J Affect Disord. 2012; 139(1):52-5. DOI: 10.1016/j.jad.2012.02.012. View

19.

Dietrich A, Ormel J, Buitelaar J, Verhulst F, Hoekstra P, Hartman C . Cortisol in the morning and dimensions of anxiety, depression, and aggression in children from a general population and clinic-referred cohort: An integrated analysis. The TRAILS study. Psychoneuroendocrinology. 2012; 38(8):1281-98. DOI: 10.1016/j.psyneuen.2012.11.013. View

20.

Dahl R, Kaufman J, Ryan N, Perel J, Al-Shabbout M, Birmaher B . The dexamethasone suppression test in children and adolescents: a review and a controlled study. Biol Psychiatry. 1992; 32(2):109-26. DOI: 10.1016/0006-3223(92)90015-r. View