Stress and the Hypothalamic Pituitary Adrenal Axis in the Developmental Course of Schizophrenia

Posted: 7 Jun 2008

See all articles by Elaine Walker

Elaine Walker

Emory University

­Vijay Mittal

Emory University

Kevin Tessner

Emory University

Abstract

Diathesis-stress models of schizophrenia and other psychotic disorders have dominated theorizing about etiology for over three decades. More recently, with advances in our understanding of the biological processes mediating the effects of stress, these models have incorporated mechanisms to account for the adverse impact of stress on brain function. This review examines recent scientific findings on the role of the hypothalamic-pituitary-adrenal (HPA) axis, one of the primary neural systems triggered by stress exposure, in the expression of vulnerability for schizophrenia. The results indicate that psychotic disorders are associated with elevated baseline and challenge-induced HPA activity, that antipsychotic medications reduce HPA activation, and that agents that augment stress hormone (cortisol) release exacerbate psychotic symptoms. The cumulative findings are discussed in light of a neural diathesis-stress model that postulates that cortisol has the potential to increase activity of dopamine pathways that have been implicated in schizophrenia and other psychotic disorders.

Keywords: schizophrenia, stress, cortisol, dopamine, hippocampus

Suggested Citation

Walker, Elaine and Mittal, ­Vijay and Tessner, Kevin, Stress and the Hypothalamic Pituitary Adrenal Axis in the Developmental Course of Schizophrenia. Annual Review of Clinical Psychology, Vol. 4, April 2008, Available at SSRN: https://ssrn.com/abstract=1141376

Elaine Walker (Contact Author)

Emory University ( email )

201 Dowman Drive
Atlanta, GA 30322
United States

­Vijay Mittal

Emory University ( email )

201 Dowman Drive
Atlanta, GA 30322
United States

Kevin Tessner

Emory University ( email )

201 Dowman Drive
Atlanta, GA 30322
United States

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