ESPE Abstracts

Objective: Oral hydrocortisone medication for Congenital Adrenal Hyperplasia (CAH) could lead to suboptimal blood cortisol levels throughout the day. In addition, the HPA-axis is rendered inflexible in patients. Cortisol is crucially involved in the stress response as well as in generating and regulating emotional responses to stimuli. Sub-optimal cortisol levels, in combination with a less flexible HPA-axis, could therefore lead to problems with emotion regulation in patients. The present study aimed to address emotion regulation skills in CAH.

Methods: 32 patients with CAH (20 females) and 37 population controls (23 females) performed an emotion regulation task. During the task, participants were asked to either upregulate, downregulate or maintain their emotional responses to negative or neutral images. During image presentation, a sound burst was presented to evoke an acoustic startle response. Emotional reactivity to the sound was measured with facial EMG of the left orbicularis oculi muscle to assess amplitude and likelihood of startle responses.

Results: Compared to controls, patients with CAH showed a smaller upregulation of acoustic startle response likelihood when viewing negative stimuli. No other differences were observed.

Conclusion: Patients seemed to have some difficulties with upregulating their emotions. Failure to upregulate startle likelihoods could potentially be associated with altered adrenal medulla function, which could be addressed by future studies. However, the effects were limited and our results rather indicate that CAH is not associated with emotion regulation problems.