Gender differences in psychological and cortisol responses to distress: A five-year follow-up of patients with back pain
Corresponding Author
Markku T. Hyyppá MD
DrMedSc, Senior Lect. (neurology)
The Rehabilitation Research Centre of the Social Insurance Institution, Psychosomatic Unit, SF-20720 Turku, Finland
The Rehabilitation Research Centre of the Social Insurance Institution, SF-20720 Turku, FinlandSearch for more papers by this authorHannu Alaranta MD, DrMedSc
The Rehabilitation Research Centre of the Social Insurance Institution, Psychosomatic Unit, SF-20720 Turku, Finland
Search for more papers by this authorMatti Hurme MD
The Rehabilitation Research Centre of the Social Insurance Institution, Psychosomatic Unit, SF-20720 Turku, Finland
Search for more papers by this authorFinn Nykvist MD
The Rehabilitation Research Centre of the Social Insurance Institution, Psychosomatic Unit, SF-20720 Turku, Finland
Search for more papers by this authorKari Lahtel PhD
The Rehabilitation Research Centre of the Social Insurance Institution, Psychosomatic Unit, SF-20720 Turku, Finland
Search for more papers by this authorCorresponding Author
Markku T. Hyyppá MD
DrMedSc, Senior Lect. (neurology)
The Rehabilitation Research Centre of the Social Insurance Institution, Psychosomatic Unit, SF-20720 Turku, Finland
The Rehabilitation Research Centre of the Social Insurance Institution, SF-20720 Turku, FinlandSearch for more papers by this authorHannu Alaranta MD, DrMedSc
The Rehabilitation Research Centre of the Social Insurance Institution, Psychosomatic Unit, SF-20720 Turku, Finland
Search for more papers by this authorMatti Hurme MD
The Rehabilitation Research Centre of the Social Insurance Institution, Psychosomatic Unit, SF-20720 Turku, Finland
Search for more papers by this authorFinn Nykvist MD
The Rehabilitation Research Centre of the Social Insurance Institution, Psychosomatic Unit, SF-20720 Turku, Finland
Search for more papers by this authorKari Lahtel PhD
The Rehabilitation Research Centre of the Social Insurance Institution, Psychosomatic Unit, SF-20720 Turku, Finland
Search for more papers by this authorAbstract
To further evaluate gender-related coping strategies, clinical and psychological characteristics of patients with low back pain were related to their serum cortisol levels on admission to hospital and at five-year follow-up after operation and/or rehabilitation.
Women expressed more somatization and depression than did men on admission, but gender difference disappeared during follow-up while depressive feeling tended to decrease. Men had more cortisol in blood in the afternoon. Sex explained a significant proportion of the variance in cortisol values at admission, whereas depression, sex and operation contributed to variance at follow-up.
It was concluded that gender differences in psychological coping with distress modify cortisol responses to the experience of low back pain.
References
- 1 Alaranta, H., Hurme, M., Lahtela, K. and Hyyppa, M. T. Prolactin and cortisol in cerebrospinal fluid: sex-related associations with clinical and psychological characteristics of patients with low back pain. Psychoendocrinology 1983; 9: 333–341.
- 2 Hyyppä, M. T., Alaranta, H., Hurme, M. and Lahtela, K. Prolactin and cortisol responses to the experience of low back pain. Pain 1985; 23: 231–242.
- 3
Sowa, C. J. and
Lustman, P. J.
Gender differences in rating stressful events, depression, and depressive cognition.
J. Clin. Psychol.
1984;
40:
1334–1337.
10.1002/1097-4679(198411)40:6<1334::AID-JCLP2270400609>3.0.CO;2-8 CAS PubMed Web of Science® Google Scholar
- 4 Haley, W. E., Turner, J. and Romano, J. M. Depression in chronic pain patients: Relation to pain, anxiety, and sex differences. Pain 1985; 23: 337–343.
- 5 Fishbain, D. A., Goldberg, M., Meagher, B. R., Steele, R. and Rosomoff, H. Male and female chronic pain patients categorized by DSM-III psychiatric diagnostic criteria. Pain 1986; 26: 181–197.
- 6 van Doornen L. J. P. Sex differences in physiological reactions to real life stress and their relationship to psychological variables. Psychophysiology 1986; 23: 657–662.
- 7 Hyyppä, M. T., Scheinin, H., Alaranta, H., Hurme, M., Lahtela, K. and Scheinin, M. Neurotransmission and the experience of low back pain; No association between CSF monoamine metabolites and pain. Pain 1985; 21: 57–65.
- 8 Gregory, R. L. Mind in Science. Weidenfeld and Nicolson, London, 1981.
- 9 Frankenhaeuser, M. Coping with job stress - a psychobiological approach. In: Working Life. B. Gar-dell and G. Johansson (Eds) Wiley, New York, 1981, pp. 213–233.
- 10 MacLean, P. D. Psychosomatic disease and the ‘visceral brain’. Recent developments bearing on the Papez theory of emotion. Psychosom. Med. 1949; 11: 338–353.
- 11 Verbrugge, L. M. Gender and health: An update on hypotheses and evidence. J. Health Soc. Behav. 1985; 26: 156–182.
- 12 Weissman, M. and Klerman, G. L. Sex differences and the epidemiology of depression. Arch. Gen. Psychiat. 1977; 34: 98–111.
- 13 Hyyppä, M. T. Psychoendocrine aspects of coping with distress. Ann. Clin. Res. 1987; 19: 78–82.
- 14 Zumoff, B., Fukushima, D. K., Weitzman, E. D., Kream, J. and Hellman, L. Sex difference in plasma cortisol concentration in man. J. Clin. Endocrinol. Metabol. 1974; 34: 805–808.
- 15 Robin, P., Predine, J. and Milgrom, E. Assay of unbound cortisol in plasma. J. Clin. Endocrinol. Metabol. 1978; 46: 277–283.
- 16 Ziegler, D. K., Hassanein, R. S., Kodanaz, A. and Meek, J. C. Circadian rhythms of plasma cortisol in migraine. J. Neural. Neurosurg. Psychiatr. 1979; 42: 741–748.
- 17
Christensen, P.,
Gram, L. F.,
Kragh-Sorensen, P.,
Christensen, L.,
Kristensen, C. B.,
Pedersen, P. L. and
Thomsen, H. Y.
Afternoon plasma cortisol in depression.
Clin. Neuropharmacol.
1984;
7:
278–279.
10.1097/00002826-198406001-00137 Google Scholar
- 18 Johansson, F. Differences in serum cortisol concentrations in organic and psychogenic chronic pain syndromes. J. Psychosom. Res. 1982; 26: 351–358.
- 19
Ursin, H.
Personality, activation and somatic health. A new psychosomatic theory. In:
Coping and Health.
S. Levine and
H. Ursin (Eds)
Plenum Press, New York,
1980,
pp. 259–279.
10.1007/978-1-4684-1042-6_13 Google Scholar
- 20 Alaranta, H., Hurme, M., Einola, A., Falck, B., Kallio, V., Knuts, L-R., Lahtela, K. and Törma, T. A prospective study of patients with sciatica: a comparison between conservatively treated and operated patients. Part 11: Results after one-year follow-up. Spine 1988 (in press).
- 21 Rauste von Wright, M., von Wright, J. and Frankenhaeuser, M. Relationships between sex-related characteristics during adolescence and catecholamine excretion during achievement stress. Psychophysiology 1981; 18: 362–370.
- 22 Johansson, G., Laakso, M-L., Karonen, S-L. and Peder, M. Examination stress affects plasma levels of TSH and thyroid hormones differently in females and males. Psychosom. Med. 1987; 49: 390–396.
