157. Anticipatory stress appraisal is differentially associated with HPA and immune acute stress responses in children with anxiety disorders

Abstract

Background: Increasing research has focused on the association of alterations in hypothalamic–pituitary–adrenal (HPA) and immune stress response systems with anxiety. This study examines the influence of state cognitive stress appraisal on these relationships. Methods: A social evaluative Cold Pressor Task (CPT) was used to elicit stress among children aged 8–12 years with an anxiety disorder (“Cases” n = 21) and healthy controls (“Controls” n = 22). Repeated saliva samples were assayed for cortisol and S-IgA to determine area under the curve (AUC) and Peak Response. Measures of anticipatory anxiety to the CPT included (1) Brief Fear of Negative Evaluation Scale (BFNE-II) and (2) Primary Appraisal Secondary Appraisal Scale (PASA). Groups were compared on biological and cognitive variables via t -tests; Pearson correlations examined relationships among cognitive variables, cortisol, and IgA within groups. Results: There were no group differences in cortisol or IgA (AUC; Peak Response), BFNE-II, or PASA. Within Cases, S-IgA AUC and Peak Response had significant negative associations with BFNE ( r = −.73, p r = −.52; p = .018, respectively) and PASA-Threat ( r = −.58, p = .006; r = −.61; p = .003, respectively), whereas only cortisol Peak Response had a significant positive association with PASA-Threat ( r = .48, p = .032); associations were not significant in Controls. Conclusions: Children with anxiety disorders who appraise acute situations as more threatening and negatively evaluative may be at increased risk for aberrant HPA and immune stress responses to acute stress.