Medication effects on salivary cortisol: tactics and strategy to minimize impact in behavioral and developmental science

Differential associations of parental harshness and parental disengagement with overall cortisol output at 15 years: Implications for adolescent mental health

Psychosocial stress in childhood and adolescence is linked to stress system dysregulation, although few studies have examined the relative impacts of parental harshness and parental disengagement. This study prospectively tested whether parental harshness and disengagement show differential associations with overall cortisol output in adolescence. Associations between overall cortisol output and adolescent mental health problems were tested concurrently. Adolescents from the Fragile Families and Child Wellbeing Study (FFCWS) provided hair samples for cortisol assay at 15 years (N = 171). Caregivers reported on parental harshness and disengagement experiences at 1, 3, 5, 9, and 15 years, and adolescents reported at 15 years. Both parent and adolescent reported depressive and anxiety symptoms and antisocial behaviors at 15. Greater parental harshness from 1-15 years, and harshness reported at 15 years in particular, was associated with higher overall cortisol output at 15. Greater parental disengagement from 1-15 years, and disengagement at 1 year specifically, was associated with lower cortisol output. There were no significant associations between cortisol output and depressive symptoms, anxiety symptoms, or antisocial behaviors. These results suggest that the unique variances of parental harshness and disengagement may have opposing associations with cortisol output at 15 years, with unclear implications for adolescent mental health.

Pubertal Timing During Early Adolescence: Advanced Pubertal Onset in Females with Autism Spectrum Disorder

Autism spectrum disorder (ASD) is characterized by impaired social communication and poor adaptation to change; thus, the onset of puberty may be a pivotal transition. This cross-sectional study measured pubertal timing to examine hypothesized differences for sex (female vs. male) and group (ASD vs. typical development [TD]). Participants included 239 children (137 ASD, 102 TD) between 10 and 13 years. The ASD group included 35 females and 102 males; the TDs included 44 females and 58 males. Pubertal onset measured by genital or pubic stage was investigated with linear regression using main effects of sex and age-by-sex interactions in TD and ASD groups and main effects of diagnosis and diagnosis-by-age interactions in males and females, controlling for body mass index, socioeconomic status, and race. In TD, examination of main effects for genital (penis/breast) stage showed no difference for male and female children (t = 1.33, P = 0.187, rdf = 92); however, there were significant differences in ASD (t = 2.70, P = 0.008, rdf = 121). For diagnosis modeled separately by sex, there was significantly earlier pubertal development in females with ASD (t = 1.97, P = 0.053, rdf = 70, but not males (t = 1.329, P = 0.186, rdf = 143). In addition, analysis of menses revealed females with ASD had significantly earlier onset than TD (t = -2.56, P = 0.018, rdf = 21). Examination of pubic stage revealed expected sex differences for TD (t = 2,674, P = 0.009, rdf = 91) and ASD (t = 3.482, P = 0.001, rdf = 121). Females with ASD evidence advanced pubertal onset relative to ASD males and TD females. Findings underscore the need for enhanced understanding of pubertal development in ASD, as differences may have significant psychological, social, physiological, and developmental consequences. LAY SUMMARY: Children with autism spectrum disorder (ASD) have difficulty with social communication and respond poorly to change, which may include the onset and course of puberty. The study measured the timing of puberty in 239 children (137 ASD and 102 typical development [TD]) between 10 and 13 years based on pubertal stage of genital (breast/penis) and pubic hair development. Females with ASD evidence advanced pubertal onset relative to ASD males and TD females. Findings underscore the need for an enhanced understanding of pubertal development in ASD.

Long-Term Associations Between Prenatal Maternal Cortisol and Child Neuroendocrine-Immune Regulation

BACKGROUND

Advancing understanding of the developmental origins of neuroendocrine-immune (NEI) functioning is key to elucidating the biological mechanisms involved in health and disease risk across the lifespan. This study examined whether prenatal maternal hypothalamic-pituitary-adrenal (HPA) activity moderates child NEI relations and explored the consistency of this moderating effect across gestation.

METHODS

Pregnant women participated in five prenatal study visits from 24 to 38 weeks gestation. At each visit, women provided a saliva sample. In a 5-year follow-up study, children (n_female = 25, n_male=20) provided four saliva samples and participated in behavioral assessments and challenge tasks. Prenatal maternal saliva samples were assayed for cortisol. Child saliva samples were assayed for cortisol and cytokines (IL-1β, IL-6, IL-8, TNFα) as indices of HPA and inflammatory activity. Multilevel mixed-effects models examined the moderation of child NEI relations by prenatal maternal cortisol.

RESULTS

Among males, average prenatal maternal cortisol did not moderate child NEI relations. Among females, average prenatal maternal cortisol moderated some child NEI relations with higher prenatal cortisol associated with more positive cortisol-cytokine relations at age five. When examined by gestational time point, there were more significant NEI moderation effects by maternal cortisol from later gestation (≥ 30 weeks) than earlier.

CONCLUSIONS

The findings suggest prenatal maternal HPA activity may moderate child NEI functioning. Additional research conducted with more heterogeneous and larger samples is needed to fully understand these relations. Furthering our knowledge of NEI development has important research and clinical implications, particularly for understanding and addressing conditions with inflammatory pathophysiologies, such as depression and cardiovascular disease.

Pubertal recalibration of cortisol-DHEA coupling in previously-institutionalized children

As a period of heightened plasticity, puberty may provide a window of opportunity for recalibration of the hypothalamic-pituitary-adrenal (HPA) axis to current conditions. Our group has recently documented evidence for pubertal recalibration of HPA axis reactivity among children internationally adopted as infants from institutions into supportive, well-resourced homes. As a first step at examining potential mechanisms by which puberty may facilitate recalibration of the HPA axis, the current study assessed whether previously-institutionalized (PI) children differed from non-adopted (NA) comparison children in levels of the adrenal steroid hormone dehydroepiandrosterone (DHEA) and in its intra-individual covariation (coupling) with cortisol by adrenal pubertal stage. In an accelerated longitudinal design, 7- to 15-year-olds completed up to 3 annual assessments, which included nurse-conducted pubertal staging and the Modified Trier Social Stress Test for Children (TSST-M). Adrenal (pubic hair) rather than gonadal pubertal stage scores were used in the analysis. Paired salivary cortisol-DHEA samples were available at 60-80 min post-TSST-M. NA and PI children did not differ in DHEA levels, which were higher among children at more advanced pubertal stages (averaged across the sessions) for both groups. For NA children, post-stressor cortisol and DHEA were positively coupled across sessions at all average adrenal pubertal stages. For PI children who were, on average, at earlier adrenal pubertal stages, post-stressor cortisol and DHEA were not coupled, but PI children who were at later pubertal stages demonstrated positive cortisol-DHEA coupling similar to that of the NA children. We suggest that these findings provide insights into processes which may underlie pubertal recalibration of the HPA axis.

Higher depressive symptoms in early adolescents with Autism Spectrum Disorder by self- and parent-report compared to typically-developing peers

BACKGROUND

Depression is more prevalent among male early adolescents with Autism Spectrum Disorder (ASD) than their typically- developing (TD) peers, but findings are limited to two male-only studies. Therefore, a broader understanding of depressive symptoms among both male and female early adolescents with ASD in larger samples is needed. Self- and parent-ratings are frequently used, yet rater differences may emerge and provide unique insights.

METHOD

Ratings of adolescent depressive symptoms were examined among 230 early adolescents (10:0-13:5 years) with and without ASD using self- (Children's Depression Inventory, Second Edition; CDI-2) and parent- report (Child Behavior Checklist; CBCL) measures. The influence of diagnostic group (ASD vs. TD) and rater (early adolescent vs. parent) on ratings were examined with Full Scale IQ and sex as covariates. Additionally, the reliability and strength of agreement between raters were examined.

RESULTS

Higher depressive symptoms were reported by both raters in the ASD group (Borderline range) compared to the TD group (Average range). The interaction of diagnostic group and rater was nonsignificant, but significant main effects emerged. Sex was a significant covariate, but Full Scale IQ was not. The reliability and strength of agreement between raters in the ASD group only were not significant.

CONCLUSIONS

Findings suggest that depressive symptoms may be higher in both male and female early adolescents with ASD across self- and parent- reports. However, measurement of depression in ASD may be complicated by nonsignificant reliability and strength of agreement between raters. Results have implications for screening and intervention for early adolescents with ASD.

Associations Among Diurnal Salivary Cortisol Patterns, Medication Use, and Behavioral Phenotype Features in a Community Sample of Rett Syndrome

Rett syndrome (RTT) is a severe neurodevelopmental disorder resulting from mutations of the MECP2 gene. Hyperactivity of the hypothalamic-pituitary-adrenal (HPA) axis and abnormal stress responses have been observed in animal models of RTT, but little is known about HPA axis function among individuals with RTT. Diurnal salivary cortisol patterns from 30 females with RTT were examined in relation to mutation type, medication use, and features of the RTT behavioral phenotype. Cortisol patterns were significantly related to mutation severity, anticonvulsant medication status, and bruxism (tooth grinding). This study provides preliminary support for the hypothesis that RTT may be at risk for outcomes associated with aberrant HPA axis function, and that this risk may be mediated by mutation type.

A systematic review of the Trier Social Stress Test methodology: Issues in promoting study comparison and replicable research

Since its development in 1993, the Trier Social Stress Test (TSST) has been used widely as a psychosocial stress paradigm to activate the sympathetic nervous system and hypothalamic-pituitary-adrenal axis (HPAA) stress systems, stimulating physiological functions (e.g. heart rate) and cortisol secretion. Several methodological variations introduced over the years have led the scientific community to question replication between studies. In this systematic review, we used the Preferred Reporting Items of Systematic Reviews and Meta-Analysis (PRISMA) to synthesize procedure-related data available about the TSST protocol to highlight commonalities and differences across studies. We noted significant discrepancies across studies in how researchers applied the TSST protocol. In particular, we highlight variations in testing procedures (e.g., number of judges, initial number in the arithmetic task, time of the collected saliva samples for cortisol) and discuss possible misinterpretation in comparing findings from studies failing to control for variables or using a modified version from the original protocol. Further, we recommend that researchers use a standardized background questionnaire when using the TSST to identify factors that may influence physiological measurements in tandem with a summary of this review as a protocol guide. More systematic implementation and detailed reporting of TSST methodology will promote study replication, optimize comparison of findings, and foster an informed understanding of factors affecting responses to social stressors in healthy people and those with pathological conditions.

Assessment of feasibility and outcomes of a salivary cortisol collection protocol in five American Indian communities

We evaluated the feasibility and outcomes of administering a naturalistic saliva collection procedure and assessment in American Indian (Indigenous) communities. We focus on Indigenous adults living with type 2 diabetes given the "epidemic" of the disease disproportionately impacting many tribal groups. Data are from community-based participatory research (CBPR) involving 5 tribal communities. Participants were randomly selected from tribal clinic records. The sample includes 188 adults living with type 2 diabetes (56% female; age range = 18-77 years; M age = 46.3 years). Participants provided a total of 748 saliva samples, representing 4 samples/participant on a single day with instructions for collection at 4 time points: upon waking, 1 h after waking, 2 h after waking, and at 8 PM. Saliva sample times were recorded by participants on paper and electronically via placement in a Medication Event Monitoring System (MEMS®) bottle. Overall, 67% of samples were completed within 10 min of protocol instructions and 91% of participants provided at least one useable sample (79% provided four useable samples). Noncompliance, behavioral and environmental factors were not robustly associated with deviations in observed cortisol indices. Results suggest that home-based, community interviewer-involved protocols yields valid data with high compliance. The success of this study was facilitated by exemplary efforts of tribal community-based interviewers and our overall CBPR approach.Lay summaryAuthentic efforts for tribal community partnerships in research are critical to successfully implementing biological assessments with American Indians given legacies of research misconduct and mistrustOur Community-Based Participatory Research with 5 tribes yielded high participant compliance to a home-based salivary cortisol collection protocolLack of compliance to salivary cortisol protocol and medication usage were not consistently associated with observed cortisol indices.

Exploring Key Physiological System Profiles at Rest and the Association with Depressive Symptoms in Autism Spectrum Disorder

Depression is often associated with dysfunction in the hypothalamic-pituitary-adrenal (HPA) axis and autonomic nervous system (ANS). Individuals with autism spectrum disorder (ASD) may experience physiological dysregulation and psychological comorbidities; however, the extent to which the interactions between these systems predict internalizing symptoms in ASD has not been investigated. The study examined interactions with the HPA axis and ANS in 10-13-year-old children with ASD (n = 41) and typical development (TD; n = 46). The interrelated systems uniquely contributed to depressive symptoms in ASD above and beyond any system in isolation. A reciprocal, parasympathetic-dominant ANS was related to fewer affective symptoms in ASD. Findings highlight the importance of examining arousal across multiple systems to more precisely identify profiles associated with maladaptive psychiatric outcomes in ASD.

Rx risk or resistance? Psychotropic medication use in relation to physiological and psychosocial functioning of psychiatric hospital workers

To avoid methodological biases, psychoneuroendocrine studies have generally excluded psychotropic medication users. In workplace stress research, this has limited our ability to understand how psychotropic medication use affects many stress-related measures of interest. In this exploratory study, the effects of psychotropic medication use on stress physiology, occupational stress, and mental health were measured in a sample of healthy adult psychiatric hospital workers (N = 203, 70 % women). Diurnal cortisol was assessed on two non-consecutive work-days at five time-points (e.g., awakening, thirty minutes after awakening, 2 P M, 4 P M and bedtime). Cortisol reactivity was assessed by exposing participants to the Trier Social Stress Test. An allostatic load index was constructed using 19 neuroendocrine, immune, cardiovascular, and metabolic biomarkers. Occupational stress (e.g., job strain, effort-reward imbalance) and psychiatric symptoms (e.g., depression, burnout) were assessed with well-validated self-reports. Results showed that psychotropic medication use had no significant effects on diurnal cortisol profiles; however, psychotropic users had significantly decreased cortisol reactivity to the Trier Social Stress Test and higher allostatic load. Psychotropic users also had decreased effort-reward imbalance, but not job strain. Depressive symptoms did not differ between psychotropic medications users and non-users; however, burnout symptoms were higher among psychotropic medication users than non-users. Taken together, our findings do not warrant the systematic exclusion of psychotropic medication users from psychoneuroendocrine studies if insights into individual differences are sought among workers and other populations exposed to elevated stress.

Reactivity of salivary uric acid in response to social evaluative stress in African Americans

High uric acid (UA) is associated with hypertension and cardiovascular disease (CVD), both of which occur disproportionately among African Americans. High UA also predicts greater blood pressure reactivity responses to acute social stress. However, whether UA itself shows reactivity in response to stress is unknown. We evaluated salivary uric acid (sUA) and blood pressure reactivity in response to acute social stress. Healthy African Americans (N = 103; 32 % male; M age = 31.36 years), completed the Trier Social Stress Test. sUA and blood pressure measurements were taken before, during and after the stressor task. sUA showed significant reactivity and recovery, especially among older African Americans. Total sUA activation was also associated with systolic and diastolic blood pressure total activation. Findings illuminate that acute stress may be a way in which UA is implicated in hypertension and CVD, suggesting a critical need to explore UA reactivity as a novel parameter of the acute stress response.

Biobehavioral Dysregulation and its Association with Obesity and Severe Obesity Trajectories from 2 to 15 Years of Age: A Longitudinal Study

OBJECTIVE

This study aimed to identify obesity trajectories from childhood to adolescence (2-15 years of age) and investigate differences in behavioral, eating, and adrenocortical regulation by trajectory membership.

METHODS

A total of 1,077 households from the National Institute of Child Health and Human Development Study of Early Child Care and Youth Development were included. Anthropometrics were measured 11 times between ages 15 months and 15 years. Behavioral self-regulation was assessed at ages 3 and 4 years. Disordered eating behaviors and awakening cortisol were assessed at age 15 years.

RESULTS

Latent growth curve modeling identified four BMI trajectories: two nonoverweight trajectories based on average BMI at the 40th and 70th percentiles and overweight/obesity and severe obesity trajectories. Youth in the severe obesity trajectory exhibited lower behavioral self-regulation in early childhood and lower awakening cortisol at age 15 years compared with youth in the nonoverweight trajectories. Youth in the overweight/obesity and severe obesity trajectories showed higher levels of disordered eating behaviors at age 15 years.

CONCLUSIONS

Obesity trajectories were associated with biobehavioral markers of dysregulation in early childhood and adolescence. Dysregulation across biobehavioral domains was particularly apparent among youth who developed severe obesity. Further work is needed to better understand resilience factors that distinguish youth who develop obesity and severe obesity from those who do not.

Cortisol and Parenting Predict Pathways to Disinhibited Social Engagement and Social Functioning in Previously Institutionalized Children

Previously institutionalized children on average show persistent deficits in physiological and behavioral regulation, as well as a lack of normative reticence towards strangers, or disinhibited social engagement (DSE). Post-adoption parenting, specifically a combination of supportive presence and structure/limit-setting, may protect against DSE over time via better adrenocortical functioning. This study examined the impact of adrenocortical activity and post-adoption parenting on DSE across the first two years post-adoption (age at adoption: 16-36 months) and observed kindergarten social outcomes in previously institutionalized children (n = 94) compared to non-adopted children (n = 52). Path analyses indicated a developmental cascade from institutional care (operationalized as a dichotomous group variable, age at adoption, and months of institutionalization) to blunted adrenocortical activity, increased DSE, and lower kindergarten social competence. Consistent with a permissive parenting style, higher parental support was associated with increased DSE, but only when not accompanied by effective structure/limit-setting. Further, parental structure reduced the association between blunted adrenocortical activity and DSE behaviors.

Pubertal Development Measurement in Children With and Without Autism Spectrum Disorder: A Comparison Between Physical Exam, Parent- and Self-Report

Adolescence is a time of remarkable biopsychosocial change, which may be particularly challenging for youth with autism spectrum disorder (ASD), necessitating enhanced understanding and accurate assessment of pubertal maturation. The study compared physical examination to parent- and self-report measures in 200 participants (134 males and 66 females) ages 10.0-13.5 years. Both participants with typical development (TD, n = 78) and ASD (n = 122) were included. Concordance ranged from slight-to-fair for self-assessments (κ = .17-.32) and slight-to-moderate for parent-report (κ = .21-.44). Concordance of physical exam with self- and parent-report of the ASD group was somewhat lower than for the TD group. Findings indicate pubertal assessments by parent or child are not reliable indices of precise pubertal staging.

Study of temporal variability of salivary cortisol and cortisone by LC-MS/MS using a new atmospheric pressure ionization source

There is a growing interest concerning the relevance of salivary cortisone levels in stress-related research. However, studies investigating morning patterns and day-to-day variability of cortisone versus cortisol levels are lacking. Cortisol and cortisone analysis by liquid chromatography-tandem mass spectroscopy (LC-MS/MS) has been widely used for routine laboratory measurements in the last years. The aim of this study was to develop an ultra-performance LC-MS/MS method for the simultaneous quantification of salivary cortisol and cortisone levels for assessing the temporal variability of these hormones. Saliva samples were collected from 18 healthy volunteers at 0, 15, and 30 min after awakening on each day for 1 week and analysed with the newly developed method. We used a novel atmospheric pressure ionization source, which resulted in high sensitivity and specificity for both cortisol and cortisone as well as higher peak values and signal-to-noise ratio as compared with the electrospray ionization source. Cortisone showed similar morning patterns as cortisol: a 25% and 49% increase in levels at 15 and 30 min after awakening, respectively. Most cortisone indices showed somewhat lower day-to-day variability and were less affected by state-related covariates. We recommend further exploration of the potential of salivary cortisone as a biomarker in stress-related research.

Child Maltreatment and Mother-Child Transmission of Stress Physiology

In the current study, we examined the attunement and transmission of mother-child diurnal cortisol among maltreating (N = 165) and nonmaltreating (N = 83) mothers and their preschool-aged children. Over half of the families had a substantiated child maltreatment case with the mother as the perpetrator. Mothers collected three saliva samples (waking, midday, and bedtime) on themselves and their child on two consecutive days, which were later assayed for cortisol. This design allows for the examination of concurrent attunement, as well as cross-lagged transmission, across the day. Results from actor-partner interdependence models revealed significant differences in mother-child cortisol attunement and transmission between the maltreating and nonmaltreating groups. Specifically, only maltreating mothers transmitted cortisol to their children and were attuned at first waking; only nonmaltreating dyads were attuned at midday. Implications of these results for sociocultural models of stress physiology and for our understanding of how child maltreatment affects diurnal cortisol regulation are discussed.

Co-activation of SAM and HPA responses to acute stress: A review of the literature and test of differential associations with preadolescents' internalizing and externalizing

Understanding co-activation patterns of the hypothalamic-pituitary-adrenal axis (HPA) and sympathetic adrenal medullary (SAM) during early adolescence may illuminate risk for development of internalizing and externalizing problems. The present study advances empirical work on the topic by examining SAM-HPA co-activation during both the reactivity and recovery phases of the stress response following acute stress exposure. Fourth and fifth grade boys and girls (N = 149) provided cortisol and alpha-amylase via saliva at seven times throughout a 95-min assessment in which they were administered the modified Trier Social Stress Test. Parents reported on adolescents' life stress, pubertal development, medication use, and externalizing problems. Adolescents reported their own internalizing symptoms. Multiple linear regressions tested both direct and interactive effects of SAM and HPA reactivity and recovery on internalizing and externalizing problems. Results from these analyses showed that whereas SAM and HPA reactivity interacted to predict internalizing symptoms, it was their interaction during the recovery phase that predicted externalizing. Concurrent high SAM and HPA reactivity scores predicted high levels of internalizing and concurrently low SAM and HPA recovery scores predicted high levels of externalizing. Implications of the findings for further study and clinical application are discussed.

Testosterone and Proactive-Reactive Aggression in Youth: the Moderating Role of Harsh Discipline

This study tests a biosocial model of the link between testosterone and proactive-reactive aggression in youth at varying levels of harsh discipline. Given that proactive aggression is used to gain power and status and the importance of social learning in its formation, we hypothesized that testosterone would be associated with proactive aggression at higher levels of harsh discipline, and that this relationship would be more pronounced in boys than girls. Participants (n = 445; 50% male; M age = 11.92 years; 80% African-American) and their caregivers completed questionnaires including demographics, conflict tactics, and proactive-reactive aggression. Youth also provided a saliva sample for testosterone. Analyses revealed an interaction between testosterone and harsh discipline on proactive aggression in both boys and girls, and an interaction between testosterone and harsh discipline on reactive aggression in boys only. For those experiencing high levels of harsh discipline, testosterone was positively associated with proactive aggression, with the magnitude of the association increasing as harsh discipline increased. For below average levels of harsh discipline, there were protective effects of high testosterone for boy's reactive aggression and for girl's proactive aggression. The findings support basic tenets of the biosocial model which suggest that links between testosterone and aggressive behavior are dependent on contextual forces, highlighting the complex relationship between hormones, social context, and aggression. Novel findings include protective effects of high testosterone for those exposed to low levels of harsh discipline. Findings are discussed in light of the context-contingency effect and also within the differential susceptibility framework.

Early neglect is a key determinant of adult hair cortisol concentration and is associated with increased vulnerability to trauma in a transdiagnostic sample

BACKGROUND

Childhood adversities and traumatic events have each been associated with hypothalamus-pituitary-adrenal (HPA) axis dysregulation and trauma-related symptoms in adulthood. Hair cortisol concentration (HCC) reflects cumulative cortisol levels over the course of months and is discussed as a potential marker between trauma-induced neuroendocrine dysfunction and trauma-related symptoms. The present study examines this hypothetical link by delineating the impact of exposure to categories of abuse and neglect during development and lifetime traumatic experiences on HCC and trauma-related symptoms.

METHODS

The Maltreatment and Abuse Chronology Exposure (MACE) scale, Life Events Checklist, and predictive analytics were used to evaluate the importance of type and timing of maltreatment and trauma load on HCC in inpatients (n = 183) with different psychiatric diagnoses. Additionally, a comparison group of n = 75 controls were recruited from the community. The extent to which the relationship between trauma load and trauma-related symptoms was influenced by childhood adversities and HCC was determined by analysis of variance.

RESULTS

Early neglect, in particular neglect at 3 years, emerged as the most important predictor of adult HCC. Post-hoc explanatory analysis showed that patients with high neglect at age 3 had lower HCC compared to patients with low neglect at age 3 and controls. Patients with high neglect at age 3 and low cortisol reported increased trauma-related symptoms upon trauma exposure.

CONCLUSION

Results strengthen evidence that inadequate care and neglect during critical periods alter HPA axis biology towards enduring reduction in cortisol, the latter being associated with augmented trauma-related symptoms upon trauma exposure. If validated by longitudinal assessments these cross-sectional findings suggest biological mechanisms of childhood adversities into psychopathology in adulthood.

The Cortisol Awakening Response: A Feasibility Study Investigating the Use of the Area Under the Curve With Respect to Increase as an Effective Objective Measure of Tinnitus Distress

Purpose Tinnitus is a chronic medical condition that can result in distress, concentration difficulties, and clinical depression. An effective, objective measure of tinnitus distress does not currently exist. Endocrinal studies into the condition have been few, with those investigating the cortisol awakening response limited in scope. It was hypothesized that distressed individuals with tinnitus would awaken and be unable to effectively prepare for the day ahead due to a blunted cortisol response. Method Twenty individuals with varying tinnitus distress were compared with a control group (n = 10) in a pilot study, which measured salivary cortisol concentrations on awakening. Multiple exclusion variables were applied. Results In line with previous studies, total cortisol volume (as measured by area under the curve) was not found to be significantly different in the most distressed individuals with tinnitus, F(2, 26) = 0.254, p = .777ns. However, a separate measure of changing cortisol levels-the area under the curve with respect to increase (or AUC_i)-was found to be significantly less robust in those individuals reporting the most severe tinnitus distress, F(2, 26) = 7.671, p = .002. This indicates that fewer resources would be available to cope with the demands of the day ahead. Additionally, the AUC_i correlated negatively with tinnitus distress later the same day. Conclusions Relationships between proposed objective and self-reported components of self-reported tinnitus distress are considered, with some aspects of tinnitus distress more closely related to physiological mechanisms than others. It is suggested that, with further research, the cortisol awakening response (AUC_i) may be put forward as a credible objective biomarker of tinnitus distress.

Extending the toxic stress model into adolescence: Profiles of cortisol reactivity

The toxic stress model posits that extended activation of stress response systems in the absence of a supportive relationship with an adult may over time lead to physiological alterations to these same systems, and ultimately to poorer physical and mental health outcomes. However, empirical tests of model hypotheses in adolescence, a critical period of development, are lacking. This study expands the toxic stress model to include more developmentally-appropriate risk and protective factors for adolescents experiencing overwhelming and uncontrollable stressors. Data were collected for a study of early adolescents from urban low-income households (N = 101; 10-12 years old; 59% female). Participants and a caregiver completed questionnaires; youths completed the modified Trier Social Stress Task alone and provided six saliva samples. Using latent profile analysis, three profiles of cortisol reactivity were identified in early adolescents exposed to chronic environmental stress: Elevated and Reactive (11%), Moderate and Non-Reactive (26%), and Blunted and Non-Reactive (63%). In accordance with the toxic stress model, exposure to more community violence and less family support were associated with blunted cortisol reactivity, and Reactive profile membership was associated with fewer trauma symptoms. Overall, the findings provide empirical support for the extension of the toxic stress model in early adolescence through the application of developmentally-sensitive measures and provide implications for future interventions.

Midlife Adults' Daily Support to Children and Parents: Implications for Diurnal Cortisol

Objectives: We examined whether providing daily support to generations above and below has a differential impact on midlife adults' diurnal cortisol. Method: Midlife adults (N = 151) from the Family Exchanges Study Wave 2 reported daily practical support, emotional support, and advice to adult children and aging parents and collected saliva samples four times a day for 4 days. Results: Midlife adults experienced steeper cortisol awakening responses and steeper declines in cortisol (favorable cortisol functioning) on days when they provided support to children. Yet, they experienced higher overall cortisol levels (unfavorable cortisol functioning) on days when they provided support to aging parents. Discussion: Providing daily support to children may be rewarding to midlife adults, but support to parents may be associated with physiological stress. Findings advance understanding of midlife adults' helping behaviors to multiple generations and carry implications for older adults' well-being by encouraging effective support strategies.

HPA axis responses to psychological challenge linking stress and disease: What do we know on sources of intra- and interindividual variability?

Stress is an ubiquitous phenomenon with significant impact on human physiology when it lasts too long, when it is too intense, or when it hits vulnerable individuals. Examining the mechanisms linking stress exposure with health and disease is an important endeavor in psychoneuroendocrine research. Empirical evidence so far revealed large intra- as well as inter-individual variability in hypothalamic-pituitary-adrenal (HPA) axis responses to acute psychosocial stress, showing that the HPA axis is a highly adaptive system. Thus, the characterization of intra- und inter-individual patterns of HPA axis reactivity is of high scientific interest and forms the basis on which mechanistic links between stress response (dys)regulation and health impairments can be examined. To date, basic knowledge has been, and still is, accumulated on demographic, biological (including genetic and epigenetic) factors, lifestyle behavioral variables, consumption of substances and medication, psychological and personality factors, as well as on methodological aspects. Besides this, there is also very recent progress in respect to the development of laboratory stress paradigms that can be applied in virtual reality or inside an MRI-scanner. In sum, the present review updates our current knowledge on moderating and intervening factors as sources of intra- und inter-individual variability in human cortisol stress responses and offers recommendations for future research designs.

Cortisol and Racial Health Disparities Affecting Black Men in Later Life: Evidence From MIDUS II

In the United States, Black men have poorer overall health and shorter life spans than most other racial/ethnic groups of men, largely attributable to chronic health conditions. Dysregulated patterns of daily cortisol, an indicator of hypothalamic-pituitary-adrenal (HPA) axis stress-response functioning, are linked to poor health outcomes. Questions remain regarding whether and how cortisol contributes to Black-White differences in men's health. This exploratory study compared early day changes in cortisol levels (diurnal cortisol slopes from peak to pre-lunch levels) and their associations with medical morbidity (number of chronic medical conditions) and psychological distress (Negative Affect Scale) among 695 Black and White male participants in the National Survey of Midlife in the United States (MIDUS II, 2004-2009). Black men exhibited blunted cortisol slopes relative to White men (-.15 vs. -.21, t = -2.97, p = .004). Cortisol slopes were associated with medical morbidity among Black men (b = .050, t = 3.85, p < .001), but not White men, and were unrelated to psychological distress in both groups. Findings indicate cortisol may contribute to racial health disparities among men through two pathways, including the novel finding that Black men may be more vulnerable to some negative health outcomes linked to cortisol. Further, results suggest that while cortisol may be a mechanism of physical health outcomes and disparities among older men, it may be less important for their emotional health. This study increases understanding of how race and male sex intersect to affect not only men's lived experiences but also their biological processes to contribute to racial health disparities among men in later life.

Diurnal Cortisol Dynamics, Perceived Stress, and Language Production in Aphasia

Purpose The current study investigated diurnal cortisol dynamics in adults with and without aphasia, along with subjective reports of stress and measures of language production. Dysregulation of cortisol, a common biomarker of stress, is associated with cognitive dysfunction in different clinical populations. However, little is known about the consequences of stress-induced cortisol disturbances for stroke survivors, including those with aphasia. Method Nineteen participants with aphasia and 14 age-matched neurotypical adults were tested. Saliva samples were collected from participants to assess the cortisol awakening response, a marker of the integrity of the hypothalamic-pituitary-adrenal (HPA) axis. Participants also completed 2 subjective stress questionnaires. Language was evaluated using 3 short, picture description narratives, analyzed for discourse (dys)fluency and productivity markers. Results In contrast to neurotypical participants, adults with aphasia did not show the predictable cortisol awakening response. Participants with aphasia also showed an unusual heightened level of cortisol upon awakening. Additionally, neurotypical participants demonstrated an association between intact language performance and the cortisol awakening response, whereas the participants with aphasia did not, although they did perceive the language tasks as stressful. Conclusion This study indicates that the functionality of the HPA axis, as indexed by cortisol, contributes to optimal language performance in healthy adults. The absence of an awakening response among participants with aphasia suggests that stroke leads to dysregulation of the HPA axis, although the degree to which this impairment affects language deficits in this population requires further investigation.

Pubertal recalibration of cortisol reactivity following early life stress: a cross-sectional analysis

BACKGROUND

Children adopted from orphanages or other such institutions tend to display blunted reactivity to stressors - even years after arriving in their generally supportive and highly resourced postadoption homes. Puberty, a proposed sensitive period for environmental influences on stress-mediating systems, may provide an opportunity for postinstitutionalized children to recalibrate stress response systems in accordance with their now more supportive living situations.

METHODS

This cross-sectional study examined the hypothalamic-pituitary-adrenocortical (HPA)-axis reactivity of 280 children ages 7 through 14 years; 122 children were adopted from institutions in 14 countries between the ages of 6 months and 5 years, after spending an average of 95% of their lives in institutional care, and 158 children of similarly high socioeconomic status in their biological families served as the nonadopted comparison group. All of the children were assessed by nurses for Tanner stage and, on a different day, completed the Trier Social Stress Test for Children.

RESULTS

Using a linear mixed-effects model and seven measures of salivary cortisol, results indicated that early-pubertal postinstitutionalized children showed blunted HPA axis reactivity compared to nonadopted children, but mid/late-pubertal postinstitutionalized children displayed higher reactivity similar to the nonadopted comparison children.

CONCLUSIONS

This is the first evidence of possible pubertal recalibration of HPA axis reactivity to a psychosocial stressor in postinstitutionalized children, which provides a promising avenue for future research regarding the protective factors of the postadoption environment and subsequent physiological, behavioral, and psychopathological outcomes.

Why and How Should We Integrate Biomarkers into Complex Trials? A Discussion on Paradigms and Clinical Research Strategies

BACKGROUND

Research in complementary and alternative medicine (CAM) encounters a variety of challenges, such as potentially synergistic, multimodal, and complex interventions which are often dependent on the relationship between practitioner and patient, on specific settings, and on patients' individual preferences, expectations, beliefs, and motivations. Moreover, patients seeking CAM care often suffer from chronic disease conditions, and multiple symptoms and/or pathologies. On the other hand, CAM interventions are often challenged as being solely dependent on subjective and nonspecific factors without biologically based mechanisms of action. If we agree that biomarkers as outcomes are important for the understanding of CAM interventions, a hypothesis- and strategy-driven process for the selection of the most appropriate biomarkers is needed.

METHODS

This paper presents the results of an expert panel on how to integrate biomarkers in whole system research of an interdisciplinary workshop on research methodology in CAM held in November 2012.

RESULTS

The following main CAM research challenges were identified: (a) finding appropriate biomarkers, which are able to picture the complex pathophysiological pathways and likewise complex interventions under study; (b) integrating these biomarkers into clinical trials in CAM; and (c) identifying the biomarkers specific to the particular CAM intervention being applied.

CONCLUSION

The paper provides a disease/condition/symptom- and intervention-driven strategy regarding how to identify the outcomes of interest and possible related biomarkers. The research approach presented here allows the selected biomarkers to be grounded in conventional physiology/pathophysiology as well as complementary and alternative concepts, including traditional systems of medicine. The goal is to provide researchers in the field with a framework on how to integrate biomarkers into complex trials.

Cognitive-affective strategies and cortisol stress reactivity in children and adolescents: Normative development and effects of early life stress

This study examined cognitive-affective strategies as predictors of hypothalamic-pituitary-adrenal (HPA) axis responses to a social-evaluative stressor in adolescence as compared to late childhood as a function of early life experiences. Participants included 159 children (9-10 years) and adolescents (15-16 years) divided into two groups based on early care experiences: non-adopted youth raised in their birth families (n = 81) and post-institutionalized youth internationally adopted from orphanage care (n = 78). Youth completed a version of the Trier Social Stress Test modified for use with children and reported on their trait emotion regulation and coping strategies. Children reported more use of suppression and disengagement than adolescents, while adolescents reported more engagement coping strategies. Non-adopted and post-institutionalized youth did not differ in reported strategies. Cognitive reappraisal predicted higher cortisol reactivity in non-adopted children and adolescents, and was not associated with reactivity in the post-institutionalized group. This study has implications for efforts aimed at promoting self-regulation and adaptive stress responses during the transition to adolescence for both typically developing children and children who experienced adverse early care.

The Dual Impact of Early and Concurrent Life Stress on Adults' Diurnal Cortisol Patterns: A Prospective Study

Major life stress often produces a flat diurnal cortisol slope, an indicator of potential long-term health problems. Exposure to stress early in childhood or the accumulation of stress across the life span may be responsible for this pattern. However, the relative impact of life stress at different life stages on diurnal cortisol is unknown. Using a longitudinal sample of adults followed from birth, we examined three models of the effect of stress exposure on diurnal cortisol: the cumulative model, the biological-embedding model, and the sensitization model. As its name implies, the cumulative model focuses on cumulative life stress. In contrast, the biological-embedding model implicates early childhood stress, and the sensitization model posits that current life stress interacts with early life stress to produce flat diurnal cortisol slopes. Our analyses are consistent with the sensitization model, as they indicate that the combination of high stress exposure early in life and high current stress predict flat diurnal cortisol slopes. These novel findings advance understanding of diurnal cortisol patterns and point to avenues for intervention.

Salivary uric acid: Associations with resting and reactive blood pressure response to social evaluative stress in healthy African Americans

High levels of uric acid are associated with greater risk of stress-related cardiovascular illnesses that occur disproportionately among African Americans. Whether hyperuricemia affects biological response to acute stress remains largely unknown, suggesting a need to clarify this potential connection. The current study examined how salivary uric acid (sUA) is associated with resting and reactive blood pressure - two robust predictors of hypertension and related cardiovascular disease and disparity. Healthy African Americans (N = 107; 32% male; M age = 31.74 years), completed the Trier Social Stress Test to induce social-evaluative stress. Systolic and diastolic blood pressure readings were recorded before, during, and after the task to assess resting and reactive change in blood pressure. Participants also provided a saliva sample at baseline that was assayed for sUA. At rest, and controlling for age, sUA was modestly associated with higher systolic (r = .201, p =  .044), but not diastolic (r = .100, p =  .319) blood pressure. In response to the stressor task, and once again controlling for age, sUA was also associated with higher total activation of both systolic (r = .219, p =  .025) and diastolic blood pressure (r = .198, p <  .044). A subsequent moderation analysis showed that associations between sUA and BP measures were significant for females, but not for males. Findings suggest that uric acid may be implicated in hypertension and cardiovascular health disparities through associations with elevated blood pressure responses to acute social stress, and that low levels of uric acid might be protective, particularly for females.

Dehydroepiandrosterone (DHEA) and its ratio to cortisol moderate associations between maltreatment and psychopathology in male juvenile offenders

This study examined whether DHEA and its ratio to cortisol moderated risk for psychopathology among incarcerated youth exposed to childhood maltreatment. Resistance to stress-related psychopathology under adversity was also examined in relation to callous-unemotional (CU) traits, a personality construct characterized by resistance to pathological anxiety and blunted reactivity to threatening stimuli. Participants were 201 ethnically heterogeneous (41.8% White, 35.3% Black, 17.2% Hispanic) adolescent boys (M age = 16.75, SD = 1.15 years) incarcerated in a juvenile detention facility in the South Eastern United States who provided four afternoon saliva samples (later assayed for DHEA and cortisol) and completed self-report questionnaires. Results indicated that childhood maltreatment was associated with greater internalizing problems at lower DHEA concentrations and at higher cortisol-to-DHEA ratios. Conversely, higher DHEA levels and lower cortisol-to-DHEA ratios were associated with greater CU traits, irrespective of maltreatment exposure. CU traits did not attenuate levels of psychopathology in maltreated youth. Findings inform biosocial models of how exposure to parental maltreatment in early life contributes to risk and resilience through mechanisms associated with adaptive environmentally sensitive biological systems and processes.

The effect of a service dog on salivary cortisol awakening response in a military population with posttraumatic stress disorder (PTSD)

Recent studies suggest a therapeutic effect of psychiatric service dogs for military veterans with posttraumatic stress disorder (PTSD), but are limited by self-report biases. The current study assessed the effect of PTSD service dogs on the salivary cortisol awakening response (CAR) and arousal-related functioning in a population of military veterans with PTSD. Participants included 73 post-9/11 military veterans with PTSD including 45 with a service dog and 28 on the waitlist to receive one. Saliva samples were collected on two consecutive weekday mornings at awakening and 30 min later to quantify the cortisol awakening response (CAR) and its area under the curve (AUCi) in addition to standardized survey measures of anxiety, anger, sleep quality and disturbance, and alcohol abuse. There was a significant main effect of having a service dog on both the CAR and the AUCi, with individuals with a service dog exhibiting a higher CAR and AUCi compared to those on the waitlist. Results also revealed that those with a service dog reported significantly lower anxiety, anger, and sleep disturbance as well as less alcohol abuse compared to those on the waitlist, with medium to large effect sizes. Although those with a service dog reported significantly less PTSD symptom severity, CAR was not significantly associated with PTSD symptoms within or across group. In conclusion, results indicate that the placement of a PTSD service dog may have a significant positive influence on both physiological and psychosocial indicators of wellbeing in military veterans with PTSD. Although clinical significance cannot be confirmed, a higher CAR/AUCi among those with a service dog may indicate better health and wellbeing in this population. Future within-subject, longitudinal research will be necessary to determine potential clinical significance and impact of individual differences.

The slope of cortisol from awakening to 30 min post-wake in post-institutionalized children and early adolescents

This study examined the association between early life adversity, in the form of early rearing in an institution (orphanage), and the slope of cortisol in the first thirty minutes after waking in 277 children, aged 7 through 15 years old, who had either been adopted between 6 and 60 months of age into well-resourced homes in the United States or born into similar homes. The adopted youth were divided at the median (age 16 months) into those adopted earlier (earlier-adopted, EA) and later (later-adopted, LA). The purpose of this study was to examine the post-waking slope in cortisol in post-institutionalized youth, predicting that it would be blunted, especially in later-adopted youth, when compared to the non-adopted (NA) youth. A secondary goal was to examine whether there would be some evidence of less blunting of the first 30 min of the cortisol awakening response among the children further along in pubertal development (i.e., Pubertal Recalibration Hypothesis). Pubertal stage was determined by nurse exam. Salivary cortisol was assessed at 0 and 30-min post-awakening on three days. The results showed that LA children had a blunted wake-30 min cortisol slope relative to NA and EA children. Neither the age by group nor pubertal stage by group analyses were significant. However, the majority of the sample were in early stages of puberty (56% in stages 1 & 2), thus the power was low for detecting such an interaction. This is the first year of a cohort-sequential longitudinal study examining early experiences and pubertal influences on the HPA axis, so it will be important to re-examine this question as the sample ages.

Childhood family adversity and adult cortisol response: The role of observed marital conflict behavior

Childhood family adversity predicts adult interpersonal behavior and physiological responses to interpersonal stress. Additionally, negative marital behaviors (e.g., hostility and distress maintaining attributions) predict maladaptive stress responses and mental health problems, whereas positive marital behaviors (e.g., acceptance and relationship enhancing attributions) predict adaptive physiological and psychological outcomes. The present study examined potential marital behavior mediators and moderators of the link between childhood adversity and cortisol responses to conflict. In a sample of 218 different-sex newlywed couples, we examined (a) actors' marital conflict behaviors as candidate mediators of the link between childhood adversity and cortisol responses to marital conflict discussions, and (b) partners' marital conflict behaviors as candidate moderators of the relation between childhood adversity and cortisol responses to marital discussions. Path analysis using actor-partner interdependence modeling did not confirm mediation. Instead, wives' childhood family adversity directly predicted husbands' attenuated cortisol responses, and wives' negative behavior predicted wives' attenuated cortisol responses. As hypothesized, wives' negative behaviors moderated the association between husbands' childhood family adversity and husbands' cortisol in response to conflict; husbands showed higher cortisol if they had experienced greater family adversity and if their wives displayed more negative behavior. Results suggest that childhood family adversity may carry forward to shape adult cortisol responses to conflict and highlights the importance of wives' negative behavior for both husbands and wives. These findings add to the family psychology literature by further clarifying how the interaction of stressful childhood experiences and conflict behaviors in marriage are associated with adult physiological responses to conflict. (PsycINFO Database Record

Differences in anticipatory versus reactive stress to social evaluative threat in adults versus adolescents with autism

Social evaluative threat is a potent activator of the hypothalamic-pituitary-adrenocortical (HPA) axis in typically developing (TD) populations. Studies have shown that children and adolescents with autism spectrum disorder (ASD) show a blunted cortisol response to this type of stressor; yet, a previous study in adults with ASD reported a more prototypical stress response. The current study compared 24 adolescents and 17 adults with ASD to investigate a possible developmental lag in autism resulting in a more adaptive stress response to social evaluation with development. Participants were exposed to the trier social stress test (TSST), and salivary cortisol was collected before and after stress induction. Multilevel modeling revealed that relative to adolescents, young adults with ASD evidenced a significant increase in cortisol in response to anticipatory stress, and 23.5% were classified as anticipatory responders. Adolescents, however, had a significant change in slope in response to the TSST, with 37.5% classified as reactive responders. In both groups, the majority of participants did not have a robust stress response to the TSST as would be expected in TD participants. Findings suggest significant differences in the cortisol trajectory; adults with ASD were more likely to show an anticipatory response to being socially evaluated, which was maintained throughout the stressor, whereas the adolescents had a more reactive response pattern with no anticipatory response. Further research is needed to determine if such patterns are adaptive or deleterious, and to determine underlying factors that may contribute to distinct stress profiles and to the overall diminished stress responses. Autism Res 2018, 11: 1276-1285. © 2018 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: Many individuals have increased stress when being socially evaluated. The current study shows that adults with ASD have increased stress in anticipation of a task in which individuals are required to give a speech to unfamiliar raters, while adolescents with ASD tend to show a stress response only during the task itself. Further research is necessary to understand whether developmental influences on stress response in ASD have significant impacts on other areas of functioning often affected by stress.

Prenatal intimate partner violence exposure predicts infant biobehavioral regulation: Moderation by the brain-derived neurotrophic factor (BDNF) gene

The ability to regulate stress is a critical developmental milestone of early childhood that involves a set of interconnected behavioral and physiological processes and is influenced by genetic and environmental stimuli. Prenatal exposure to traumatic stress and trauma, including intimate partner violence (IPV), increases risk for offspring biobehavioral regulation problems during childhood and adolescence. Although individual differences in susceptibility to prenatal stress have been largely unexplored, a handful of studies suggest children with specific genetic characteristics are most vulnerable to prenatal stress. We evaluated the brain-derived neurotrophic factor Val66Met gene (BDNF) as a moderator of the effect of prenatal IPV exposure on infant temperamental and cortisol regulation in response to a psychosocial challenge. Ninety-nine mother–infant dyads recruited from the community were assessed when infants (51% female) were 11 to 14 months. Maternal reports of IPV during pregnancy and infant temperament were obtained, and infant saliva was collected for genotyping and to assess cortisol reactivity (before and after the Strange Situation Task). Significant genetic moderation effects were found. Among infants with the BDNF Met allele, prenatal IPV predicted worse temperamental regulation and mobilization of the cortisol response, while controlling for infant postnatal exposure to IPV, other maternal traumatic experiences, and infant sex. However, prenatal IPV exposure was not associated with temperamental or cortisol outcomes among infant carriers of the Val/Val genotype. Findings are discussed in relation to prenatal programming and biological susceptibility to stress.

In Individuals Following Aneurysmal Subarachnoid Haemorrhage, Hair Cortisol Concentrations Are Higher and More Strongly Associated with Psychological Functioning and Sleep Complaints than in Healthy Controls

BACKGROUND

Following an aneurysmal subarachnoid haemorrhage (aSAH), many patients report persistent deficits in psychological functioning, characterised by high levels of stress and symptoms of depression, low life satisfaction, along with poor sleep. Such deficits have been associated with altered saliva and serum cortisol levels due to a dysregulation of hypothalamic-pituitary-adrenal axis activity (HPA-AA). However, hair cortisol concentrations (HCCs) have not been assessed in this population, although this method allows a long-term insight into cortisol values. Therefore, the objective of this study was to compare HCCs in aSAH patients and healthy controls and to examine how HCCs are associated with perceived stress, psychological functioning, and sleep complaints.

METHODS

In this cross-sectional study, data on depressive symptoms, hypochondriacal beliefs, life satisfaction, and sleep complaints were gathered in 15 aSAH patients and 17 healthy controls. HCCs of the previous 3 months were assessed.

RESULTS

aSAH patients had significantly higher HCCs than healthy controls. In aSAH patients, higher HCCs were significantly associated with increased depressive symptoms, hypochondriacal beliefs, lower life satisfaction, and increased sleep complaints. Such significant associations were not found in healthy controls.

CONCLUSIONS

Our findings indicate that a dysregulation of HPA-AA is associated with some of the long-term impairments in psychological functioning and sleep in aSAH survivors. While the direction of association remained unclear, a dysregulated HPA-AA may be causally linked with the maintenance of poor psychological functioning and poor sleep. The overall findings should be considered in the planning of long-term treatment aimed at improving psychological functioning and sleep in aSAH patients.

Household fear of deportation in relation to chronic stressors and salivary proinflammatory cytokines in Mexican-origin families post-SB 1070

Sociologists recognize that immigration enforcement policies are forms of institutionalized racism that can produce adverse health effects in both undocumented and documented Latinos and Mexican-origin persons in the United States. Despite this important advancement, little research examines the relationship between fear of immigration enforcement and biobehavioral health in mixed-status Mexican-origin families. This study applies an embodiment of racism approach to examine how household fear of deportation (FOD) is related to differences in salivary proinflammatory cytokines (IL-1 β , IL-6, IL-8, and TNF α ) in healthy Mexican-origin families with at least one immigrant, living in Phoenix, AZ. Participants were 111 individuals (n=46 adults, 72% female; n=65 children, 49% female) from 30 low-income, mixed-status families. During a home visit, anthropometric measures and saliva were collected from each family member and a household survey was administered. Saliva was assayed for salivary IL-1 β , IL-6, IL-8, and TNF α . Random effects multilevel structural equation models estimated the relationship between household FOD and a salivary proinflammatory cytokine latent variable between families, while controlling for other chronic stressors (economic/occupational, immigration, parental, and family conflict). Household FOD ( β =0.68, p=0.04) and family conflict chronic stress ( β =1.96, p=0.03) were strongly related to elevated levels of proinflammatory cytokines between families. These results were consistent in non-mixed and mixed-status families. Future research is needed to characterize what aspects of living with an undocumented family member shape the physical health outcomes of persons with authorized status or US-citizenship.

Family conflict, chaos, and negative life events predict cortisol activity in low-income children

Childhood poverty is hypothesized to increase risk for mental and physical health problems at least in part through dysregulation of the hypothalamic-pituitary-adrenal axis. However, less is known about the specific psychosocial stressors associated with cortisol reactivity and regulation for children living in poverty. The current study investigates negative life events, household chaos, and family conflict in preschool and middle childhood as potential predictors of cortisol regulation in low-income 7-10 year olds (N = 242; M age = 7.9 years). Participants were assessed in preschool and participated in a follow-up assessment in middle childhood, during which diurnal free cortisol and free cortisol reactivity to the Trier Social Stress Test for Children (TSST-C) were assessed. Household chaos during preschool predicted a more blunted diurnal cortisol slope in middle childhood. Greater negative life events during preschool and greater concurrent family conflict were associated with increased free cortisol reactivity in middle childhood.

No Evidence for a Relationship Between Hair Testosterone Concentrations and 2D:4D Ratio or Risk Taking

Using a recently developed alternative assay procedure to measure hormone levels from hair samples, we examined the relationships between testosterone, cortisol, 2D:4D ratio, overconfidence and risk taking. A total of 162 (53 male) participants provided a 3 cm sample of hair, a scanned image of their right and left hands from which we determined 2D:4D ratios, and completed measures of overconfidence and behavioral risk taking. While our sample size for males was less than ideal, our results revealed no evidence for a relationship between hair testosterone concentrations, 2D:4D ratios and risk taking. No relationships with overconfidence emerged. Partially consistent with the Dual Hormone Hypothesis, we did find evidence for the interacting effect of testosterone and cortisol on risk taking but only in men. Hair testosterone concentrations were positively related to risk taking when levels of hair cortisol concentrations were low, in men. Our results lend support to the suggestion that endogenous testosterone and 2D:4D ratio are unrelated and might then exert diverging activating vs. organizing effects on behavior. Comparing our results to those reported in the existing literature we speculate that behavioral correlates of testosterone such as direct effects on risk taking may be more sensitive to state-based fluctuations than baseline levels of testosterone.

Adult adiposity linked to relationship hostility for low-cortisol reactors

Past research on the relation between hostility in intimate relationships and adiposity has yielded mixed findings. The present study investigated whether the association between relationship hostility and adiposity is moderated by people's biological reactions to couple conflict. Cohabiting adult couples (N = 117 couples) engaged in two conflict interactions, before and after which salivary cortisol levels were measured. Results revealed an association between relationship hostility and adiposity, but this association was concentrated among people with relatively low levels of cortisol reactivity to couple conflict. Results are interpreted in light of research demonstrating that cortisol reactivity can become blunted over time in response to repeated stressors. These results provide precision to etiological models of obesity by identifying cortisol reactivity as a factor that moderates the association between relationship hostility and adiposity. (PsycINFO Database Record

Here Today, Gone Tomorrow? Changes in 4-Month-Olds' Physiologic and Behavioral Responses Do Not Indicate Memory for a Social Stressor

Although much is known about early memory development, only a few studies have explored infants' memory of social stress. While these few studies suggest that infants can remember stressful interactions, limitations seen in both methodology and statistical analyses give pause. In the current study, 4-month-olds and their mothers participated in both stressful and non-stressful interactions over 2 days. On Day 1, memory group infants participated in the double Face-to-Face Still-Face (FFSF) paradigm and control group infants participated in typical play. Both groups experienced the double FFSF paradigm on Day 2. Memory group infants exhibited the standard SF response but no differences in infant cortisol on Day 1. Both infant groups exhibited the standard SF response on Day 2. However, infants in the memory group, who saw the FFSF paradigm for the second time, did not demonstrate changes in cortisol or behavior indicative of memory across the 2 days. There was also no relationship between changes in cortisol and behavior for both days. The findings question the use of salivary cortisol as a measure of social stress and suggest that, although 4-month-olds reacted to the Still-Face social stressor immediately, they did not remember the following day.

Stress-buffering effects of volunteering on salivary cortisol: Results from a daily diary study

Based on the theoretical foundations of the caregiving system model, which holds that prosocial behavior can be conceptualized in relation to a neurobiological stress-buffering mechanism, we addressed the question of whether daily volunteering yields buffering effects in terms of suppressing a neuroendocrine response (i.e., salivary cortisol) to daily stressors. We used daily diary data from the second wave of the National Study of Daily Experiences (NSDE II), which is part of the Midlife in the United States study (MIDUS II), a nationally representative survey of middle-aged and older adults. Analyzing a sample of volunteers (N = 340), we tested the buffering role of daily volunteer work for the same day stressors-salivary cortisol response relationship (person-day observations, N = 1,042). Findings from multilevel models indicated that the relationship between daily stressors and cortisol output was attenuated on days when volunteering was performed compared to days volunteering was not performed. Our findings are suggestive of a unique, but unobserved, neurobiological mechanism underlying the link between volunteering and better health. Volunteer programs designed to help others in need may be considered as an intervention strategy for individuals living under stressful conditions.

Person-centered examination of salivary cortisol and alpha-amylase responses to psychosocial stress: Links to preadolescent behavioral functioning and coping

This study adopted a person-centered approach to identify preadolescent salivary cortisol (sC) and alpha-amylase (sAA) co-activation response patterns and examine links to behavioral functioning and coping. Children (N = 151, 51.7% male) were exposed to the Trier Social Stress Test (TSST) and one of two randomly-assigned, post-TSST coping conditions: distraction or avoidance. Multi-trajectory modeling yielded four child subgroups. Child internalizing and externalizing positively predicted High sC-High sAA relative to Low sC-Low sAA and Low sC-High sAA relative to High sC-Low sAA subgroup membership, respectively. Low sC-Low sAA children demonstrated more efficient sC recovery when primed with distraction and more protracted sC recovery when primed with avoidance. For High sC-High sAA, internalizing children, the opposite was true. Findings illustrate adjustment-linked variability in preadolescent sC-sAA co-activation response patterns that further articulates for whom effortful coping works to effectively manage stressor-induced neuroendocrine activation.

Interactions between observer and stimuli fertility status: Endocrine and perceptual responses to intrasexual vocal fertility cues

Both men and women find female voices more attractive at higher fertility times in the menstrual cycle, suggesting the voice is a cue to fertility and/or hormonal status. Preference for fertile females' voices provides males with an obvious reproduction advantage, however the advantage for female listeners is less clear. One possibility is that attention to the fertility status of potential rivals may enable women to enhance their own reproductive strategies through intrasexual competition. If so, the response to having high fertility voices should include hormonal changes that promote competitive behavior. Furthermore, attention and response to such cues should vary as a function of the observer's own fertility, which influences her ability to compete for mates. The current study monitored variation in cortisol and testosterone levels in response to evaluating the attractiveness of voices of other women. All 33 participants completed this task once during ovulation then again during the luteal phase. The voice stimuli were recorded from naturally cycling women at both high and low fertility, and from women using hormonal birth control. We found that listeners rated high fertility voices as more attractive compared to low fertility, with the effect being stronger when listeners were ovulating. Testosterone was elevated following voice ratings suggesting threat detection or the anticipation of competition, but no stress response was found.