Major Depression is a stress-related disorder characterized by altered hypothalamic-pituitary-adrenal axis function. Mindfulness-based interventions have shown to improve subjective parameters of stress and to reduce relapse rates in depressed patients. However, research on their effects on diurnal patterns of cortisol and associations with subjective outcomes is lacking. The present Ambulatory Assessment study investigated possible changes in daily rhythm cortisol parameters (cortisol awakening response (CAR), daily slope, total cortisol) in currently remitted individuals with recurrent depression who were randomized to a four-week mindfulness-based focused attention training (MBAT, n = 39) or a progressive muscle relaxation training (PMR, n = 39). A second aim was to investigate whether changes in cortisol were linked to improvements in affective and cognitive daily life states. On three weekdays before and after the intervention, seven saliva cortisol samples per day were collected. For analysis, multilevel models were applied. Results revealed no group-specific or general change in CAR and daily slopes from pre- to postintervention. In contrast, total cortisol increased across groups, which was however moderated by group and subjective improvement status. While cortisol increased irrespective of subjective improvement in PMR participants, MBAT participants with larger reductions in negative affect and rumination maintained their initial cortisol levels, whereas those with lower improvement paralleled the PMR group. Thereby, MBAT appeared to buffer an increase in overall cortisol secretion over time, but only in patients showing marked improvements in those affective and cognitive states that constitute core elements for depressive relapses in the vulnerability model of mindfulness-based cognitive therapy.

中文翻译：

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基于正念的集中注意力训练与缓解型抑郁症患者的渐进式肌肉放松：对唾液皮质醇的影响以及与日常生活主观改善的关联

重度抑郁症是一种与压力相关的疾病，其特征是下丘脑-垂体-肾上腺轴功能改变。基于正念的干预已被证明可以改善压力的主观参数并降低抑郁症患者的复发率。然而，缺乏关于它们对皮质醇昼夜模式的影响以及与主观结果的关联的研究。本动态评估研究调查了目前缓解的复发性抑郁症患者的日常节律皮质醇参数（皮质醇觉醒反应 (CAR)、每日斜率、总皮质醇）的可能变化，这些患者被随机分配到为期 4 周的正念集中注意力训练 (MBAT) , n = 39) 或渐进式肌肉放松训练 (PMR, n = 39)。第二个目的是调查皮质醇的变化是否与情感和认知日常生活状态的改善有关。在干预前后的三个工作日，每天收集七个唾液皮质醇样本。为了分析，应用了多级模型。结果显示，从干预前到干预后，CAR 和每日斜率没有组特定或一般变化。相比之下，各组的总皮质醇增加，但受组和主观改善状态的影响。虽然皮质醇增加与 PMR 参与者的主观改善无关，但负面影响和反刍减少较大的 MBAT 参与者保持其初始皮质醇水平，而那些改善较低的参与者与 PMR 组平行。从而，