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Cortisol responsivity in chronic schizophrenia: The effects of treatment environment
Abstract
Cortisol secretion has predictable features including a stable diurnal rhythm with additional secretory activity occurring to challenging, stressful or novel events followed by rapid habituation with subsequent exposure to the same stimuli. The present study examined cortisol functioning in long-term hospitalized chronic schizophrenic individuals under two conditions: the everyday ambient environment of a hospital ward and during exposure to a novel, challenging situation. A subsequent retest four months later examined whether habituation had occurred following reexposure to the challenge task. Subjects were drawn from two treatment environments that differed in level of active treatment programming. One was an intensive, Biopsychosocial Rehabilitation Program that provided an all waking hours active treatment program aimed at building functional skills. The second was a custodial ward where the primary focus of treatment was psychotropic medications in the context of custodial care. The findings indicated that treatment environment was related to cortisol responsivity. Subjects from the active treatment program showed an expected increase in cortisol while completing a challenging, novel task at time-one and no increase in cortisol at time-two, suggesting habituation to the task. They also showed stability in cortisol taken under ambient ward environment conditions. Subjects from a custodial ward had lower levels of cortisol overall and did not show an expected increase in cortisol during challenge and showed instability in cortisol taken during ambient environment. Previous research finds a pattern of cortisol dysregulation in schizophrenia characterized by tendencies towards hyporesponsivity and hyperresponsivity. The current research suggests that active treatment programming that provides opportunities for daily challenge may lead to a normalizing of cortisol response in chronic schizophrenic individuals. HPAC dysfunction in chronic schizophrenic populations and the implications for treatment programming is discussed.
Subject Area
Psychotherapy|Neurology|Mental health
Recommended Citation
Partridge, Sonia Anne, "Cortisol responsivity in chronic schizophrenia: The effects of treatment environment" (1994). ETD collection for University of Nebraska-Lincoln. AAI9516590.
https://digitalcommons.unl.edu/dissertations/AAI9516590