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Liebert MA, Urlacher SS, Madimenos FC, Gildner TE, Cepon-Robins TJ, Harrington CJ, Bribiescas RG, Sugiyama LS, Snodgrass JJ. Variation in diurnal cortisol patterns among the Indigenous Shuar of Amazonian Ecuador. Am J Hum Biol 2024:e24056. [PMID: 38517108 DOI: 10.1002/ajhb.24056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2023] [Revised: 12/24/2023] [Accepted: 02/09/2024] [Indexed: 03/23/2024] Open
Abstract
OBJECTIVES The hypothalamic-pituitary-adrenal (HPA) axis and its primary end product, the glucocorticoid cortisol, are major components of the evolved human stress response. However, most studies have examined these systems among populations in high-income settings, which differ from the high pathogen and limited resource contexts in which the HPA axis functioned for most of human evolution. METHODS We investigated variability in diurnal salivary cortisol patterns among 298 Indigenous Shuar from Amazonian Ecuador (147 males, 151 females; age 2-86 years), focusing on the effects of age, biological sex, and body mass index (BMI) in shaping differences in diurnal cortisol production. Saliva samples were collected three times daily (waking, 30 minutes post-waking, evening) for three consecutive days to measure key cortisol parameters: levels at waking, the cortisol awakening response, the diurnal slope, and total daily output. RESULTS Age was positively associated with waking levels and total daily output, with Shuar juveniles and adolescents displaying significantly lower levels than adults (p < .05). Sex was not a significant predictor of cortisol levels (p > .05), as Shuar males and females displayed similar patterns of diurnal cortisol production across the life course. Moreover, age, sex, and BMI significantly interacted to moderate the rate of diurnal cortisol decline (p = .027). Overall, Shuar demonstrated relatively lower cortisol concentrations than high-income populations. CONCLUSIONS This study expands the documented range of global variation in HPA axis activity and diurnal cortisol production and provides important insights into the plasticity of human stress physiology across diverse developmental and socioecological settings.
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Affiliation(s)
- Melissa A Liebert
- Department of Anthropology, Northern Arizona University, Flagstaff, Arizona, USA
| | - Samuel S Urlacher
- Department of Anthropology, Baylor University, Waco, Texas, USA
- Child and Brain Development Program, CIFAR, Toronto, Ontario, Canada
| | - Felicia C Madimenos
- Department of Anthropology, Queens College (CUNY), Flushing, New York, USA
- New York Consortium of Evolutionary Primatology (NYCEP), CUNY Graduate Center, New York, New York, USA
| | - Theresa E Gildner
- Department of Anthropology, Washington University in St. Louis, St. Louis, Missouri, USA
| | - Tara J Cepon-Robins
- Department of Anthropology, University of Colorado, Colorado Springs, Colorado, Springs, Colorado, USA
| | | | | | | | - J Josh Snodgrass
- Department of Anthropology, University of Oregon, Eugene, Oregon, USA
- Center for Global Health, University of Oregon, Eugene, Oregon, USA
- Global Station for Indigenous Studies and Cultural Diversity, Hokkaido University, Sapporo, Japan
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Moyers SA, Hagger MS. Physical Activity and Cortisol Regulation: A Meta-Analysis. Biol Psychol 2023; 179:108548. [PMID: 37001634 DOI: 10.1016/j.biopsycho.2023.108548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 03/24/2023] [Accepted: 03/27/2023] [Indexed: 03/31/2023]
Abstract
Physical activity participation is associated with effective stress coping, indicated by decreases in both physiological stress reactivity and perceived stress. Quantifying the effect of physical activity on the diurnal regulation of one key physiological stress indicator, the stress hormone, cortisol, across studies may demonstrate the extent to which physical activity participation is associated with diurnal HPA axis regulation. We meta-analyzed studies examining relations between physical activity participation and indices of HPA axis regulation: the diurnal cortisol slope and the cortisol awakening response. We also examined moderators of the relation. The analysis revealed a small, non-zero negative averaged correlation between physical activity and the diurnal cortisol slope (r = -0.043, 95% CI [-0.080, -0.004]). Examination of sample sociodemographic differences, study design characteristics, cortisol measurement methods, and physical activity variables as moderators revealed few effects on the relation between physical activity and diurnal cortisol slope. We did not observe lower levels of variability in the mean cortisol awakening response at higher levels of physical activity participation, and moderator analyses showed little evidence of reductions in heterogeneity for this effect. We found some evidence of systematic publication bias. Findings suggest higher physical activity is associated with a steeper diurnal cortisol slope. However, the cortisol awakening response did not differ by physical activity level. Future studies testing the physical activity and cortisol regulation association should use standardized physical activity measures, follow guidelines for better quality cortisol sampling collection and analysis, and test relations in large-scale empirical studies to confirm the direction and causality of the effect.
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Affiliation(s)
- Susette A Moyers
- Department of Psychological Sciences, University of California, Merced, USA; Center for Rural Health, Oklahoma State University Center for Health Sciences, Tulsa, OK, USA
| | - Martin S Hagger
- Department of Psychological Sciences, University of California, Merced, USA; Health Sciences Research Institute, University of California, Merced, USA; Faculty of Sport and Health Sciences, University of Jyväskylä, Finland; School of Applied Psychology, Griffith University, Australia
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Bate G, Buscemi J, Greenley RN, Tran S, Miller SA. Salivary cortisol levels and appraisals of daily hassles across dimensions of the tripartite model of anxiety and depression in emerging adults. Biol Psychol 2023; 176:108469. [PMID: 36460125 DOI: 10.1016/j.biopsycho.2022.108469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 10/13/2022] [Accepted: 11/28/2022] [Indexed: 11/30/2022]
Abstract
The objective of this study was to investigate how cortisol levels and appraisals of daily hassles differ across tripartite dimensions of depression and anxiety in emerging adults. Data collected from a sample of undergraduate students at a large Midwestern university was used to investigate these aims. This included salivary cortisol data collected over four days, scores on a measure of the tripartite model of anxiety and depression, and scores on a measure of daily hassles administered everyday for two weeks. Generalized estimating equations and multilevel modeling techniques were used to analyze data. Elevated cortisol levels during the awakening period and the evening period, lower total levels across the day, steeper diurnal slopes, and elevated levels of negative affect and physiological hyperarousal predicted experiences of daily hassles. Tripartite dimensions were unrelated to cortisol indices. The present study demonstrates the utility of modeling multiple cortisol indices and provides evidence of differential associations between physiological and phenomenological indices of stress.
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Affiliation(s)
- George Bate
- Department of Psychology, Rosalind Franklin University of Medicine and Science, USA.
| | | | - Rachel Neff Greenley
- Department of Psychology, Rosalind Franklin University of Medicine and Science, USA
| | - Susan Tran
- Department of Psychology, DePaul University, USA
| | - Steven A Miller
- Department of Psychology, Rosalind Franklin University of Medicine and Science, USA
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Joseph NT, Jiang Y, Zilioli S. Momentary emotions and salivary cortisol: A systematic review and meta-analysis of ecological momentary assessment studies. Neurosci Biobehav Rev 2021; 125:365-379. [PMID: 33662445 DOI: 10.1016/j.neubiorev.2021.02.042] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Revised: 01/21/2021] [Accepted: 02/25/2021] [Indexed: 12/19/2022]
Abstract
An integrated view of the stress response requires consideration of both the emotional and hormonal sequelae of stress, which are regulated by the hypothalamic-pituitary-adrenal (HPA) axis. Understanding the extent of the association between emotions and cortisol at the momentary level can shed light on the biopsychological pathways linking stress to health. Research in this area has adopted heterogeneous approaches and produced mixed findings; thus, it is critical to conduct a systematic review and meta-analysis. Systematic searches in major databases identified 22 studies (negative emotions [k = 19; 38,418 momentary observations]; positive emotions [k = 15; 31,721 momentary observations]). Meta-analysis found a significant positive association between momentary negative emotions and cortisol (r = .06, p < .001) and a significant negative association between momentary positive emotions and cortisol (r = -.05, p = .003). No methodological differences moderated these associations. Our findings suggest that emotional states correlate with cortisol levels at the momentary level. We discuss the health implications of our findings and provide recommendations for advancing this area of research.
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Affiliation(s)
| | - Yanping Jiang
- Department of Psychology, Wayne State University, United States
| | - Samuele Zilioli
- Department of Psychology, Wayne State University, United States; Department of Family Medicine and Public Health Sciences, Wayne State University, United States.
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Bakouni H, Ouimet MC, Forget H, Vasiliadis HM. Temporal patterns of anxiety disorders and cortisol activity in older adults. J Affect Disord 2020; 277:235-243. [PMID: 32836030 DOI: 10.1016/j.jad.2020.08.020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Revised: 08/01/2020] [Accepted: 08/05/2020] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Studies focusing on anxiety temporal patterns and cortisol activity in older adults are scarce. The objectives of this study were to examine in older adults the relationship between anxiety temporal patterns and cortisol activity and ascertain the presence of sex differences. METHODS Data were retrieved from the Étude sur la santé des ainés - Services study in Quebec and included N = 762 community living adults aged ≥ 65 years having participated in interviews at baseline (T1) and at 4 years follow-up (T2). A standardized questionnaire, based on DSM-5 criteria, was used to ascertain in the past 6 months the presence of anxiety (absence, remission, incidence, persistence). Cortisol activity during the interview and cortisol concentration on a regular day (at T2) were the dependent variables. Adjusted multivariable linear regression models, stratified by sex, were used. RESULTS Results showed higher cortisol activity during the interview in participants with anxiety in remission (Beta: 2.59; 95% CI: 0.62 , 4.57), specifically in males, and lower activity in participants with persistent anxiety (Beta: -3.97; 95% CI: -7.05, -0.88). Cortisol concentration on a regular day was higher in males reporting incident anxiety (Beta: 8.07; 95% CI: 2.39 , 13.76). LIMITATIONS The convenience sample with losses to follow-up may have led to a potential selection bias. CONCLUSION Anxiety temporal patterns were associated with cortisol activity profiles in older adults with sex being a significant moderator. Future studies are recommended to ascertain the longitudinal changes in cortisol activity and anxiety temporal patterns, which may further inform personalized treatment of anxiety.
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Affiliation(s)
- Hamzah Bakouni
- Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Longueuil, Quebec, Canada; Centre de recherche Charles-Le Moyne - Saguenay-Lac-Saint-Jean sur les innovations en santé (CR-CSIS), Longueuil, Quebec, Canada
| | - Marie Claude Ouimet
- Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Longueuil, Quebec, Canada; Centre de recherche Charles-Le Moyne - Saguenay-Lac-Saint-Jean sur les innovations en santé (CR-CSIS), Longueuil, Quebec, Canada
| | - Helen Forget
- Université du Québec en Outaouais, Gatineau, Canada
| | - Helen-Maria Vasiliadis
- Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Longueuil, Quebec, Canada; Centre de recherche Charles-Le Moyne - Saguenay-Lac-Saint-Jean sur les innovations en santé (CR-CSIS), Longueuil, Quebec, Canada.
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Stress-Related Trajectories of Diurnal Cortisol in Older Adulthood Over 12 Years. Psychoneuroendocrinology 2020; 121:104826. [PMID: 32866774 DOI: 10.1016/j.psyneuen.2020.104826] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Revised: 07/23/2020] [Accepted: 07/23/2020] [Indexed: 12/11/2022]
Abstract
OBJECTIVE Although evidence shows that stress experiences can predict both hyper- and hypo-cortisol regulation, there is a lack of research examining these associations longitudinally. Our study assessed whether levels and increases in psychological stress experiences predicted 12-year changes in circadian cortisol levels (area under the curve; AUC) and cortisol slopes in a sample of community-dwelling older adults. METHODS In 2004, 190 community dwelling older adults (57 to 94 years) started providing three days of diurnal cortisol and stress experience data every two years for a total of seven waves of data. All analyses controlled for relevant covariates including: SES, BMI, age, sex, cortisol-related medication, chronic illness, and smoking status. RESULTS Growth-curve modeling documented that compared to participants who reported generally lower stress experiences (T-ratio = -5.57, p < .01), their counterparts with higher stress experiences showed significantly steeper declines in cortisol AUC over time (T-ratio = -9.23, p < .01). Higher stress experience was associated with generally flatter cortisol slopes. In addition, among participants with high and increasing stress experience over 12 years, cortisol slopes became increasingly flatter over time (T-ratio = 2.78, p < .01). CONCLUSIONS Among individuals with high, as compared to low, levels of chronic stress experience, cortisol levels displayed steeper declines across the study period. Moreover, cortisol slopes became increasingly flatter as a function of high and increasing stress experience. Implications for theory and research on the associations between stress experience and cortisol in the context of longitudinal observations are discussed.
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Lee CH, Sinclair D, O'Donnell M, Galletly C, Liu D, Weickert CS, Weickert TW. Transcriptional changes in the stress pathway are related to symptoms in schizophrenia and to mood in schizoaffective disorder. Schizophr Res 2019; 213:87-95. [PMID: 31296417 DOI: 10.1016/j.schres.2019.06.026] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2018] [Revised: 06/25/2019] [Accepted: 06/27/2019] [Indexed: 01/07/2023]
Abstract
Altered levels of stress-signalling transcripts have been identified in post-mortem brains of people with schizophrenia, and since stress effects may be expressed throughout the body, there should be similar changes in peripheral cells. However, the extent to which these markers are altered in peripheral white blood cells of people with schizophrenia is not known. Furthermore, how peripheral cortisol and stress-related mRNA are associated with negative symptom severity and emotional states in people with schizophrenia versus schizoaffective disorder has not been determined. Whole blood samples were collected from 86 patients with either schizophrenia or schizoaffective disorder (56 people with schizophrenia and 30 people with schizoaffective disorder), and 77 healthy controls. Total RNA was isolated, cDNA was synthesized, and stress-signalling mRNA levels (for NR3C1, FKBP5, FKBP4, PTGES3 and BAG1) were determined. Stress and symptom severity scores were measured by the Depression, Anxiety and Stress Scale, and the Positive and Negative Syndrome Scale, respectively. We found increased FKBP5 mRNA, Z(156) = 2.5, p = 0.01, decreased FKBP4 mRNA, t(155) = 3.5, p ≤ 0.001, and decreased PTGES3 mRNA, t(153) = 3.0, p ≤ 0.01, in schizophrenia and schizoaffective disorder cohorts combined compared to healthy controls. Stress-related peripheral mRNA levels were differentially correlated with negative emotional states and symptom severity in schizoaffective disorder (β's = -0.45-0.56, p's = 0.05-0.001) and schizophrenia (β's = -0.34-0.38, p's = 0.04-0.03), respectively. Therefore, molecules of the stress-signalling pathway appear to differentially contribute to clinical features of schizophrenia versus schizoaffective disorder.
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Affiliation(s)
- Cynthia H Lee
- School of Psychiatry, Faculty of Medicine, University of New South Wales, Sydney, NSW 2052, Australia; Schizophrenia Research Laboratory, Neuroscience Research Australia, Randwick, NSW 2031, Australia
| | | | - Maryanne O'Donnell
- School of Psychiatry, Faculty of Medicine, University of New South Wales, Sydney, NSW 2052, Australia; Prince of Wales Hospital, Randwick, New South Wales, Australia
| | - Cherrie Galletly
- Discipline of Psychiatry, University of Adelaide, South Australia, Australia; Northern Adelaide Local Health Network, Australia; Ramsay Health Care (SA) Mental Health, Australia
| | - Dennis Liu
- Discipline of Psychiatry, University of Adelaide, South Australia, Australia; Northern Adelaide Local Health Network, Australia
| | - Cynthia Shannon Weickert
- School of Psychiatry, Faculty of Medicine, University of New South Wales, Sydney, NSW 2052, Australia; Schizophrenia Research Laboratory, Neuroscience Research Australia, Randwick, NSW 2031, Australia; Department of Neuroscience and Physiology, Upstate Medical University, Syracuse, NY 13210, USA
| | - Thomas W Weickert
- School of Psychiatry, Faculty of Medicine, University of New South Wales, Sydney, NSW 2052, Australia; Schizophrenia Research Laboratory, Neuroscience Research Australia, Randwick, NSW 2031, Australia; Department of Neuroscience and Physiology, Upstate Medical University, Syracuse, NY 13210, USA.
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Teychenne M, Stephens LD, Costigan SA, Olstad DL, Stubbs B, Turner AI. The association between sedentary behaviour and indicators of stress: a systematic review. BMC Public Health 2019; 19:1357. [PMID: 31647002 PMCID: PMC6813058 DOI: 10.1186/s12889-019-7717-x] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Accepted: 09/30/2019] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Emerging evidence shows sedentary behaviour may be associated with mental health outcomes. Yet, the strength of the evidence linking sedentary behaviour and stress is still unclear. This study aimed to synthesise evidence regarding associations between time spent in sedentary behaviour and stress in adults. METHODS A systematic search was conducted (January 1990 - September 2019). Following PRISMA guidelines, an evaluation of methodological quality, and best-evidence synthesis of associations between time in sedentary behaviour (including sitting time, TV viewing, computer use) and stress were presented. Twenty-six studies reporting on data from n = 72,795 people (age 18-98y, 62.7% women) were included. RESULTS Across the studies (n = 2 strong-, n = 10 moderate- and n = 14 weak-quality), there was insufficient evidence that overall time spent in sedentary behaviour and sitting time were associated with stress, particularly when using self-report measures of sedentary behaviour or stress. There was strong evidence of no association between TV viewing, or computer use and stress. Amongst studies using objective measures of sedentary behaviour and/or stress there was also strong evidence of no association. CONCLUSION Although previous research suggested sedentary behaviour may be linked to mental health outcomes such as depression and anxiety, the evidence for an association between various types of sedentary behaviour and stress is limited in quality, and associations are either inconsistent or null. High-quality longitudinal/interventional research is required to confirm findings and determine the direction of associations between different contexts (i.e. purpose) and domains (i.e. leisure, occupational, transport) of sedentary behaviour and stress.
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Affiliation(s)
- Megan Teychenne
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia.
| | - Lena D Stephens
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
| | - Sarah A Costigan
- School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
| | - Dana Lee Olstad
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Brendon Stubbs
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Anne I Turner
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
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Fiacco S, Walther A, Ehlert U. Steroid secretion in healthy aging. Psychoneuroendocrinology 2019; 105:64-78. [PMID: 30314729 DOI: 10.1016/j.psyneuen.2018.09.035] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2018] [Revised: 09/25/2018] [Accepted: 09/26/2018] [Indexed: 01/16/2023]
Abstract
Nowadays, people spend a considerable amount of their lives as older adults, but this longer lifespan is often accompanied by an increase in chronic conditions and disease, resulting in reduced quality of life and unprecedented societal and economic burden. Healthy aging is therefore increasingly recognized as a healthcare priority. Physical and mental adaptations to changes over the life course, and the maintenance of well-being, represent pivotal challenges in healthy aging. To capture the complexity of healthy aging, we propose a specific phenotype based on body composition, cognition, mood, and sexual function as indicators of different dimensions of healthy aging. With increasing age, sex hormones as well as glucocorticoids undergo significant alterations, and different patterns emerge for women and men. This review describes age-related patterns of change for women and men, and sheds light on the underlying mechanisms. Furthermore, an overview is provided of the challenges for healthy aging resulting from these age-related steroid alterations. While clinical practice guidelines recommend hormonal treatment only in the case of consistently low hormone levels and symptoms of hormone deficiency, physical exercise and a healthy lifestyle emerge as preventive strategies which can counter age-related hormonal changes and at best prevent chronic conditions.
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Affiliation(s)
- Serena Fiacco
- Clinical Psychology and Psychotherapy, University of Zurich, Zurich, Switzerland; URPP Dynamics of Healthy Aging Research Priority Program, University of Zurich, Zurich, Switzerland
| | - Andreas Walther
- Clinical Psychology and Psychotherapy, University of Zurich, Zurich, Switzerland; Biopsychology, TU Dresden, Dresden, Germany
| | - Ulrike Ehlert
- Clinical Psychology and Psychotherapy, University of Zurich, Zurich, Switzerland; URPP Dynamics of Healthy Aging Research Priority Program, University of Zurich, Zurich, Switzerland.
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Valera-Calero A, Lluch Girbés E, Gallego-Izquierdo T, Malfliet A, Pecos-Martín D. Endocrine response after cervical manipulation and mobilization in people with chronic mechanical neck pain: a randomized controlled trial. Eur J Phys Rehabil Med 2019; 55:792-805. [PMID: 30621368 DOI: 10.23736/s1973-9087.19.05475-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
BACKGROUND Most of the research on the effects of spinal manipulation on endocrine function has been done on healthy subjects and has yielded contradictory results. The potential role of cervical manual therapy intervention in order to induce changes in the endocrine system has not yet been investigated. AIM The aim of this trial is to compare the effects on salivary cortisol levels and clinical outcomes of cervical manipulation versus cervical mobilization or sham manipulation in patients with chronic mechanical neck pain. DESIGN Randomized controlled trial. SETTING University of Alcala de Henares: outpatient (referrals from office workers). POPULATION A total of 83 patients with chronic mechanical neck pain. METHODS Participants were randomized to receive one session of cervical manipulation, cervical mobilization, or sham manipulation. The measured variables were salivary cortisol levels, neck pain and disability, pressure pain thresholds (PPT), and cervical range of motion (ROM). They were obtained at baseline, immediately after treatment (except neck disability), and at one-week follow-up (except cortisol). RESULTS A significant and comparable increase in cortisol levels was observed immediately after cervical manipulation and mobilization (both P<0.001). Neck disability improved to a similar degree in the cervical manipulation and mobilization groups at the one-week follow-up (both P<0.001). Neck pain was reduced immediately after cervical manipulation (P<0.001), cervical mobilization (P=0.001), and sham manipulation (P<0.001). There were no significant changes in most ROM directions after either treatment. No significant interaction effect was observed for PPT. CONCLUSIONS Cervical manipulation and mobilization resulted in a similar increase in cortisol concentrations immediately post-treatment in people with chronic mechanical neck pain. Supraspinal mechanisms may thus play a role in the hypoalgesic effects that follow the application of both interventions. CLINICAL REHABILITATION IMPACT The increase in cortisol levels was similar with cervical manipulation and mobilization so induced stress levels can be similar in both interventions.
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Affiliation(s)
| | - Enrique Lluch Girbés
- Department of Physical Therapy, University of Valencia, Valencia, Spain - .,Department of Physiotherapy, Human Physiology and Anatomy (KIMA), Faculty of Physical Education and Physiotherapy, Free University of Brussels, Brussels, Belgium
| | | | - Anneleen Malfliet
- Department of Physical Therapy, University of Valencia, Valencia, Spain.,Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, Ghent University, Campus Heymans, Ghent, Belgium
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Stress load of emergency service: effects on the CAR and HRV of HEMS emergency physicians on different working days (N = 20). Int Arch Occup Environ Health 2018; 92:155-164. [PMID: 30315367 DOI: 10.1007/s00420-018-1362-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2017] [Accepted: 09/25/2018] [Indexed: 12/11/2022]
Abstract
PURPOSE The occupation of the emergency physicians (EPs) of helicopter emergency medical services (HEMS) can be characterized as a high-strain occupation (Karasek in Adm Sci Q 24(2):285-308. https://doi.org/10.2307/2392498 , 1979). Therefore, the aim of this study was to measure and compare the stress load of the EPs of HEMS on duty on air ambulance workdays and on 2 control days. METHODS In this field study (within-subjects design), hormonal, physiological, and self-perceived stress levels of 20 EPs [3 females, 17 males; mean age (M) = 44.95 years, SD = 4.80, 95% confidence interval (CI) (42.71, 47.19)] of HEMS, were recorded on different test days. Measurements of the cortisol awakening response (CAR) and the heart rate variability (HRV) were performed while on duty on the air ambulance and during workdays at the outpatient clinic as well as at home on days of rest. RESULTS There were significant differences in the CAR (area under the curve with respect to ground F(2,38) = 12.81, p < 0.001) between the 3 test days with the highest values on the workday at the outpatient clinic [M = 81.24; 98.75% CI (61.24, 101.24)] and not on the air ambulance day [M = 61.82; 98.75% CI (45.18, 78.46)] or on the day of rest [M = 52.96; 98.75% CI (38.17, 67.76)]. In addition, the HRV parameter SDNN [F(2,38) = 6.369; p = 0.004] presented significant differences between the 3 test days with lower levels on the day at the outpatient clinic [M = 101.44; 98.75% CI (83.50, 119.38)] in contrast to the air ambulance day [M = 120.16; 98.75% CI (100.02, 140.30)] and to the resting day [M = 123.79; 98.75% CI (106.49, 141.10)]. Furthermore, there were significant differences in the HRV parameter LF/HF [F(2,38) = 6.215; p = 0.005] between the 3 testing days with the highest values on the workday at the outpatient clinic [M = 8.69; 98.75% CI (6.29, 11.09)] compared to the air ambulance day [M = 6.54; 98.75% CI (4.50, 8.57)] and the day of rest [M = 6.43; 98.75% CI (4.57, 8.29)]. CONCLUSIONS Compared with the standard values and previous studies, EPs of HEMS have an increase in hormonal reactivity in the morning and a lack of recovery of the ANS. It can be concluded that-with respect to the psychobiological stress model by McEwen and Lasley (The end of stress as we know it, National Academic Press, Washington, 2003)-work-related stressors persist too long or the stress response is exaggerated (allostatic load) due to chronic stress induction and lack of recovery.
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Self-compassion, chronic age-related stressors, and diurnal cortisol secretion in older adulthood. J Behav Med 2018; 41:850-862. [DOI: 10.1007/s10865-018-9943-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2017] [Accepted: 05/30/2018] [Indexed: 12/20/2022]
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De Sousa SMC, Sheriff N, Tran CH, Menzies AM, Tsang VHM, Long GV, Tonks KTT. Fall in thyroid stimulating hormone (TSH) may be an early marker of ipilimumab-induced hypophysitis. Pituitary 2018; 21:274-282. [PMID: 29380110 DOI: 10.1007/s11102-018-0866-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
PURPOSE Hypophysitis develops in up to 19% of melanoma patients treated with ipilimumab, a cytotoxic T-lymphocyte antigen-4 antibody. Early detection may avert life-threatening hypopituitarism. We aimed to assess the incidence of ipilimumab-induced hypophysitis (IH) at a quaternary melanoma referral centre, and to determine whether cortisol or thyroid stimulating hormone (TSH) monitoring could predict IH onset. METHODS We performed a retrospective cohort study of ipilimumab-treated patients at a quaternary melanoma referral centre in Australia. The inclusion criteria were patients with metastatic or unresectable melanoma treated with ipilimumab monotherapy, and cortisol and TSH measurements prior to ≥ 2 infusions. The main outcomes were IH incidence and TSH and cortisol patterns in patients who did and did not develop IH. RESULTS Of 78 ipilimumab-treated patients, 46 met the study criteria and 9/46 (20%) developed IH at a median duration of 13.0 weeks (range 7.7-18.1) following ipilimumab initiation. All patients whose TSH fell ≥ 80% compared to baseline developed IH, and, in 5/9 patients with IH, TSH fell prior to cortisol fall and IH diagnosis. Pre-cycle-4 TSH was significantly lower in those who developed IH (0.31 vs. 1.73 mIU/L, P = 0.006). TSH fall was detected at a median time of 9.2 (range 7.7-16.4) weeks after commencing ipilimumab, and a median of 3.6 (range of - 1.4 to 9.7) weeks before IH diagnosis. There was no difference in TSH between the groups before cycles 1-3 or in cortisol before cycles 1-4. CONCLUSIONS TSH fall ≥ 80% may be an early marker of IH. Serial TSH measurement during ipilimumab therapy may be an inexpensive tool to expedite IH diagnosis.
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Affiliation(s)
- Sunita M C De Sousa
- Endocrine and Metabolic Unit, Royal Adelaide Hospital, Adelaide, Australia
- Department of Genetics and Molecular Pathology, Centre for Cancer Biology, an SA Pathology and University of South Australia Alliance, Adelaide, Australia
- School of Medicine, University of Adelaide, Adelaide, Australia
| | - Nisa Sheriff
- Department of Endocrinology, St Vincent's Hospital, Darlinghurst, Australia
- Diabetes and Metabolism Program, Garvan Institute of Medical Research, Darlinghurst, Australia
| | - Chau H Tran
- Department of Endocrinology, St Vincent's Hospital, Darlinghurst, Australia
- St Vincent's Clinical School, University of New South Wales, Sydney, Australia
| | - Alexander M Menzies
- Melanoma Institute Australia, Wollstonecraft, Australia
- Royal North Shore Hospital, St Leonards, Australia
- University of Sydney, Camperdown, Australia
- Mater Hospital, North Sydney, Australia
| | - Venessa H M Tsang
- Royal North Shore Hospital, St Leonards, Australia
- Mater Hospital, North Sydney, Australia
- Kolling Institute of Medical Research, St Leonards, Australia
| | - Georgina V Long
- Melanoma Institute Australia, Wollstonecraft, Australia
- Royal North Shore Hospital, St Leonards, Australia
- University of Sydney, Camperdown, Australia
- Mater Hospital, North Sydney, Australia
| | - Katherine T T Tonks
- Department of Endocrinology, St Vincent's Hospital, Darlinghurst, Australia.
- Diabetes and Metabolism Program, Garvan Institute of Medical Research, Darlinghurst, Australia.
- St Vincent's Clinical School, University of New South Wales, Sydney, Australia.
- Mater Hospital, North Sydney, Australia.
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14
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Gaffey AE, Bergeman CS, Clark LA, Wirth MM. Aging and the HPA axis: Stress and resilience in older adults. Neurosci Biobehav Rev 2016; 68:928-945. [PMID: 27377692 PMCID: PMC5621604 DOI: 10.1016/j.neubiorev.2016.05.036] [Citation(s) in RCA: 146] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2015] [Revised: 05/19/2016] [Accepted: 05/20/2016] [Indexed: 12/29/2022]
Abstract
Hypothalamic-pituitary-adrenal (HPA) axis function may change over the course of aging, and altered diurnal or stress-induced secretion of the hormone cortisol could predispose older adults to negative health outcomes. We propose that psychological resilience may interact with diurnal cortisol to affect health outcomes later in life. Emotion regulation and social support are two constructs that contribute to resilience and exhibit age-specific patterns in older adults. Determining how the use of resilience resources interacts with age-related diurnal cortisol will improve our understanding of the pathways between stress, resilience, and well-being. In this review, we assess published studies evaluating diurnal cortisol in older adults to better understand differences in their HPA axis functioning. Evidence thus far suggests that diurnal cortisol may increase with age, although cross-sectional studies limit the conclusions that can be drawn. We also review extant evidence connecting age-specific signatures of emotion regulation and social support with diurnal cortisol. Conclusions are used to propose a preliminary model demonstrating how resilience resources may modulate the effects of cortisol on health in aging.
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Affiliation(s)
- Allison E Gaffey
- 118 Haggar Hall, Department of Psychology, University of Notre Dame, Notre Dame, IN 46556, United States.
| | - C S Bergeman
- 118 Haggar Hall, Department of Psychology, University of Notre Dame, Notre Dame, IN 46556, United States
| | - Lee Anna Clark
- 118 Haggar Hall, Department of Psychology, University of Notre Dame, Notre Dame, IN 46556, United States
| | - Michelle M Wirth
- 118 Haggar Hall, Department of Psychology, University of Notre Dame, Notre Dame, IN 46556, United States
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15
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Cremeans-Smith JK, Greene K, Delahanty DL. Physiological Indices of Stress Prior to and Following Total Knee Arthroplasty Predict the Occurrence of Severe Post-Operative Pain. PAIN MEDICINE 2016; 17:970-9. [PMID: 26814277 DOI: 10.1093/pm/pnv043] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/15/2015] [Accepted: 09/27/2015] [Indexed: 11/14/2022]
Abstract
OBJECTIVE The severe pain and disability associated with osteoarthritis often motivate individuals to undergo arthroplastic surgery. However, a significant number of surgical patients continue to experience pain following surgery. Prior research has implicated both the hypothalamic-pituitary-adrenal (HPA) axis and sympathetic nervous system (SNS) in the sensitization of pain receptors and chronic pain conditions. This study uses a prospective, observational, cohort design to examine whether physiological stress responses before and after surgery could predict post-operative pain severity. SUBJECTS Participants included 110 patients undergoing total knee arthroplasty. METHODS Physiological indices of stress included the measurement of catecholamine and cortisol levels in 15-hour urine samples collected prior to and 1 month following surgery, as well as in-hospital heart rate and blood pressure (before and after surgery), which were abstracted from medical records. Patients completed the pain subscale of the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) [Bellamy et al., J Orthop Rheumatol 1: , 95 (1988)] 2.5 weeks prior to surgery and at a 3-month follow-up. RESULTS Contrary to expectations, lower stress hormone levels at baseline were related to more severe post-operative pain. Data at later time points, however, supported our hypothesis: cardiovascular tone shortly before surgery and urinary levels of epinephrine 1 month following surgery were positively related to pain severity 3 months later. CONCLUSION Results suggest that the occurrence of post-operative pain can be predicted on the basis of stress physiology prior to and following arthroplastic surgery.
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Affiliation(s)
- Julie K Cremeans-Smith
- *Department of Psychological Sciences, Kent State University at Stark, North Canton, Ohio;
| | - Kenneth Greene
- Department of Orthopedics, Cleveland Clinic, Cleveland, Ohio
| | - Douglas L Delahanty
- Department of Psychological Sciences, Kent State University, Kent, Ohio; Department of Psychology in Psychiatry, Northeast Ohio Medical University (NEOMED), Rootstown, Ohio, USA
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16
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Spataro R, Volanti P, Vitale F, Meli F, Colletti T, Di Natale A, La Bella V. Plasma cortisol level in amyotrophic lateral sclerosis. J Neurol Sci 2015; 358:282-6. [PMID: 26384616 DOI: 10.1016/j.jns.2015.09.011] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2015] [Revised: 08/17/2015] [Accepted: 09/03/2015] [Indexed: 12/12/2022]
Abstract
BACKGROUND Amyotrophic Lateral sclerosis (ALS) is associated with a significant distress, being linked to changes in hypothalamic-pituitary-adrenal axis activity. A loss of cortisol circadian rhythmicity in ALS patients was suggested,while more recently an increased plasma cortisol level in the disease has been reported. OBJECTIVE To assay the circadian plasma cortisol level in ALS and to study its relationship with the clinical phenotype and the rate of disease progression. PATIENTS AND METHODS 135 ALS patients (Bulbar, 33; Spinal, 102;M/F=1.73) and 110 controls (not affected by neurological or psychiatric disorders, free of drugs; M/F=1.75) were recruited. Disease progression was scored with ΔFS.Morning and evening plasma cortisol levels (μg/dl)were assayed from fasting ALS patients and controls using Elecsys® Cortisol Immunoassay System. RESULTS We found that the morning level of cortisol in ALS patients was higher than controls (morning: ALS, 15.2[11.5-18.9] vs Controls, 11.4 [8.8 -14.3], p b 0.001; evening: ALS, 7.5[4.7–11.8] vs Controls, 7.9[5.4–10.0], p=0.6).Furthermore, the hormone's level was higher in the spinal-onset group (Spinal, 15.9[11.9–19.0] vs Bulbar,13.5[10.1–18.6] vs controls, 11.4[8.8–14.3], p b 0.001) and in patients with intermediate/rapid disease course. CONCLUSIONS Morning plasma cortisol level is increased in ALS, mainly in spinal-onset patients and in those with intermediate/rapidly progressing disease. The plasmatic changes of the steroid hormone appear however too small to make it a sensitive biochemical marker in this severe neurodegenerative disease.
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Affiliation(s)
- Rossella Spataro
- ALS Clinical Research Centre, Department of Experimental Biomedicine and Clinical Neurosciences (BioNeC), University of Palermo, 90129 Palermo, Italy
| | - Paolo Volanti
- Neurorehabilitation Unit, ALS Center, S Maugeri Foundation, Mistretta, Italy
| | - Francesco Vitale
- Dept of Sciences for Health Promotion, University of Palermo, 90127 Palermo, Italy
| | - Francesco Meli
- Dept of Sciences for Health Promotion, University of Palermo, 90127 Palermo, Italy
| | - Tiziana Colletti
- ALS Clinical Research Centre, Department of Experimental Biomedicine and Clinical Neurosciences (BioNeC), University of Palermo, 90129 Palermo, Italy
| | - Antonino Di Natale
- Neurorehabilitation Unit, ALS Center, S Maugeri Foundation, Mistretta, Italy
| | - Vincenzo La Bella
- ALS Clinical Research Centre, Department of Experimental Biomedicine and Clinical Neurosciences (BioNeC), University of Palermo, 90129 Palermo, Italy.
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Hajat A, Moore K, Do DP, Stein Merkin S, Punjabi NM, Sáñchez BN, Seeman T, Diez-Roux AV. Examining the cross-sectional and longitudinal association between diurnal cortisol and neighborhood characteristics: Evidence from the multi-ethnic study of atherosclerosis. Health Place 2015; 34:199-206. [PMID: 26073509 DOI: 10.1016/j.healthplace.2015.05.017] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2014] [Revised: 05/26/2015] [Accepted: 05/28/2015] [Indexed: 11/26/2022]
Abstract
We examined cross-sectional and longitudinal associations between neighborhood socioeconomic status, social cohesion and safety and features of the diurnal cortisol curve including: area under the curve (AUC), wake-to-bed slope, wake-up, cortisol awakening response (CAR, wake-up to 30 min post-awakening), early decline (30 min to 2 h post-awakening) and late decline (2 h post-awakening to bed time). In cross-sectional analyses, higher neighborhood poverty was associated with a flatter early decline and a flatter wake-to-bed slope. Higher social cohesion and safety were associated with higher wake-up cortisol, steeper early decline and steeper wake-to-bed slope. Over 5 years, wake-up cortisol increased, CAR, early decline, late decline and wake-to-bed slope became flatter and AUC became larger. Higher poverty was associated with less pronounced increases in wake-up and AUC, while higher social cohesion was associated with greater increases in wake-up and AUC. Adverse neighborhood environments were cross-sectionally associated with flatter cortisol profiles, but associations with changes in cortisol were weak and not in the expected direction.
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Affiliation(s)
- Anjum Hajat
- University of Washington, School of Public Health, Department of Epidemiology, 4225 Roosevelt Way NE, Suite 303, Seattle, WA 98105, USA.
| | - Kari Moore
- Drexel University, School of Public Health, Department of Epidemiology and Biostatistics, Nesbitt Hall, 3215 Market Street, Philadelphia, PA 19104, USA.
| | - D Phuong Do
- University of Wisconsin Milwaukee, Zilber School of Public Health, Department of Epidemiology and Public Health Policy and Administration, 1240 N, 10th Street, Milwaukee, WA 53201, USA.
| | - Sharon Stein Merkin
- University of California Los Angeles, David Geffen School of Medicine, Department of Medicine, Division of Geriatrics, 10945 Le Conte Avenue, Suite 2339, Los Angeles, CA 90095, USA.
| | - Naresh M Punjabi
- Johns Hopkins University, Division of Pulmonary and Critical Care Medicine, 5501 Hopkins Bayview Circle, Room 4B.36, Baltimore, MD 21224, USA
| | - Brisa Ney Sáñchez
- University of Michigan, School of Public Health, Department of Biostatistics, 1415 Washington Heights, M4124 SPH II, Ann Arbor, MI 48109, USA.
| | - Teresa Seeman
- University of California Los Angeles, David Geffen School of Medicine, Department of Medicine, Division of Geriatrics, 10945 Le Conte Avenue, Suite 2339, Los Angeles, CA 90095, USA.
| | - Ana V Diez-Roux
- Drexel University, School of Public Health, Department of Epidemiology and Biostatistics, Nesbitt Hall, 3215 Market Street, Philadelphia, PA 19104, USA.
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18
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Vilela LHM, Juruena MF. Avaliação do funcionamento do eixo HPA em deprimidos por meio de medidas basais: revisão sistemática da literatura e análise das metodologias utilizadas. JORNAL BRASILEIRO DE PSIQUIATRIA 2014. [DOI: 10.1590/0047-2085000000031] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Objetivo Realizar revisão sistemática da literatura para conhecer a atividade do eixo hipotálamo-pituitária-adrenal (HPA) em deprimidos considerando-se as medidas basais dos hormônios e analisar criticamente as metodologias utilizadas. Métodos Foi realizada busca de artigos nas bases de dados PubMed e SciELO. Na primeira base de dados, introduziram-se as palavras-chave “depressive disorder” e “HPA axis”, e na segunda utilizaram-se os termos “depression” ou “depressão” e “HHA” ou “HPA axis”. Optou-se por pesquisa realizada em humanos adultos, em inglês e português, do ano 2000 até 2011. Resultados Dos 27 artigos selecionados, obtiveram-se como resposta do eixo HPA tanto hiperatividade como atividade desregulada, hipoatividade ou não alteração. Tais resultados dependem das variáveis e dos hormônios estudados, do fluido coletado – plasma, urina, saliva, líquido cefalorraquidiano – do horário de coleta, do número de coletas, da análise estatística utilizada, do subtipo de doença depressiva, entre outros. Conclusão: Os resultados não apresentam consenso em relação à atividade do eixo HPA. Considerando as variáveis estudadas, o eixo HPA, na maioria das vezes, apresenta-se disfuncional na presença da depressão.
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19
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Holland JM, Rengifo J, Currier JM, O'Hara R, Sudheimer K, Gallagher-Thompson D. Psychosocial predictors of salivary cortisol among older adults with depression. Int Psychogeriatr 2014; 26:1-9. [PMID: 24735686 DOI: 10.1017/s1041610214000489] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
ABSTRACT Background: Previous studies have identified a number of psychosocial risk factors of dysregulated cortisol (frequently referred to as the "stress hormone") among older adults with depression. However, these studies have typically only examined a handful of risk factors at a time and have sometimes yielded inconsistent results. Method: This study aims to address this gap in the literature by simultaneously examining a range of relevant psychosocial predictors of diurnal cortisol among 54 older adults with a depressive disorder. Salivary cortisol was assessed upon awakening, at 5 PM, and at 9 PM across two consecutive days. Participants also completed measures of global psychosocial stress, current psychiatric symptomatology, pervasive distress (e.g. history of past depression), and protective factors (e.g. social support, resiliency, extent to which one has "made sense" of a significant stressor). Results: High levels of current depressive symptoms, psychiatric comorbidities, past depressive episodes, trait anxiety, and poorer ability to make sense of one's stress were found to be associated with flatter (more abnormal) cortisol slopes. However, when all of these variables were entered simultaneously in a multiple regression analysis, only history of past depression and the degree of sense made of stress emerged as unique predictors of cortisol in the model. Conclusions: These findings have important implications for identifying depressed elderly individuals with dysregulated cortisol patterns who may be most at risk for health complications. Treatments that aim to limit the chronicity of depression and help to increase the sense made of stress could potentially have a positive impact on health.
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Affiliation(s)
- Jason M Holland
- Department of Psychology, University of Nevada, Las Vegas, Nevada, USA
| | | | | | - Ruth O'Hara
- Stanford University School of Medicine, Stanford, California, USA
| | - Keith Sudheimer
- Stanford University School of Medicine, Stanford, California, USA
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20
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Nater UM, Hoppmann CA, Scott SB. Diurnal profiles of salivary cortisol and alpha-amylase change across the adult lifespan: evidence from repeated daily life assessments. Psychoneuroendocrinology 2013; 38:3167-71. [PMID: 24099860 PMCID: PMC3844069 DOI: 10.1016/j.psyneuen.2013.09.008] [Citation(s) in RCA: 94] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2013] [Revised: 09/09/2013] [Accepted: 09/09/2013] [Indexed: 11/28/2022]
Abstract
Salivary cortisol and alpha-amylase are known to have distinctive diurnal profiles. However, little is known about systematic changes in these biomarkers across the adult lifespan. In a study of 185 participants (aged 20-81 years), time-stamped salivary cortisol and alpha-amylase were collected 7 times/day over 10 days. Samples were taken upon waking, 30 min later, and then approximately every 3 h until 9 pm. Multilevel models showed that older age was associated with increased daily cortisol secretion as indicated by greater area under the curve, attenuated wake-evening slopes, and more pronounced cortisol awakening responses. Further, older age was related to greater daily alpha-amylase output and attenuated wake-evening slopes. No age differences were observed regarding the alpha-amylase awakening response. Our findings may contribute to a better understanding of age-related differences in functioning of stress-related systems.
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Affiliation(s)
- Urs M. Nater
- University of Marburg, Dept. of Psychology, Marburg 35032, Germany
| | | | - Stacey B. Scott
- The Pennsylvania State University, Center for Healthy Aging, University Park, PA 16802, USA
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21
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Kovach CR, Woods DL, Devine EC, Logan BR, Raff H. Biobehavioral measures as outcomes: a cautionary tale. Res Gerontol Nurs 2013; 7:56-65. [PMID: 24158972 DOI: 10.3928/19404921-20131018-01] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2013] [Accepted: 10/04/2013] [Indexed: 11/20/2022]
Abstract
This article discusses the use of biobehavioral measures as outcomes for health care intervention studies. Effect size (ES) values for salivary cortisol and observation-based measures of pain and agitation were examined. Effects pre to post treatment were assessed separately for nursing home residents with and without acute psychotic symptoms. This study revealed large positive effects on both pain and agitation measures in the group with acute psychotic symptoms and small-to-medium positive effects on these same measures in the group without acute psychotic symptoms. In both of these groups, the ES values were not consistently positive on the cortisol measures. Prior to determining whether a measure can be used to estimate minimum clinically important differences, it is essential to consider if the biomarker will be responsive to therapy in the populations and contexts being studied.
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22
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Smyth N, Hucklebridge F, Thorn L, Evans P, Clow A. Salivary Cortisol as a Biomarker in Social Science Research. SOCIAL AND PERSONALITY PSYCHOLOGY COMPASS 2013. [DOI: 10.1111/spc3.12057] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Nina Smyth
- Department of Psychology; University of Westminster
| | | | - Lisa Thorn
- Department of Psychology; University of Westminster
| | - Phil Evans
- Department of Psychology; University of Westminster
| | - Angela Clow
- Department of Psychology; University of Westminster
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23
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Zoladz PR, Diamond DM. Current status on behavioral and biological markers of PTSD: a search for clarity in a conflicting literature. Neurosci Biobehav Rev 2013; 37:860-95. [PMID: 23567521 DOI: 10.1016/j.neubiorev.2013.03.024] [Citation(s) in RCA: 188] [Impact Index Per Article: 17.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2012] [Revised: 03/23/2013] [Accepted: 03/27/2013] [Indexed: 12/24/2022]
Abstract
Extensive research has identified stereotypic behavioral and biological abnormalities in post-traumatic stress disorder (PTSD), such as heightened autonomic activity, an exaggerated startle response, reduced basal cortisol levels and cognitive impairments. We have reviewed primary research in this area, noting that factors involved in the susceptibility and expression of PTSD symptoms are more complex and heterogeneous than is commonly stated, with extensive findings which are inconsistent with the stereotypic behavioral and biological profile of the PTSD patient. A thorough assessment of the literature indicates that interactions among myriad susceptibility factors, including social support, early life stress, sex, age, peri- and post-traumatic dissociation, cognitive appraisal of trauma, neuroendocrine abnormalities and gene polymorphisms, in conjunction with the inconsistent expression of the disorder across studies, confounds attempts to characterize PTSD as a monolithic disorder. Overall, our assessment of the literature addresses the great challenge in developing a behavioral and biomarker-based diagnosis of PTSD.
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Affiliation(s)
- Phillip R Zoladz
- Department of Psychology, Sociology, & Criminal Justice, Ohio Northern University, 525 S. Main St., Ada, OH, 45810, USA
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24
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Piazza JR, Charles ST, Stawski RS, Almeida DM. Age and the association between negative affective states and diurnal cortisol. Psychol Aging 2012; 28:47-56. [PMID: 23088196 DOI: 10.1037/a0029983] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The current study examined age differences in the association between daily negative affect, average negative affect, and diurnal cortisol among participants from the National Study of Daily Experiences (N = 1,423; age range: 33-84 years). Across four consecutive days, participants reported the negative emotions they experienced and provided four saliva samples per day, from which cortisol was assayed. Results revealed that higher levels of average negative affect were associated with greater daily cortisol output (area-under-the-curve, with respect to ground), but only among the older participants in our sample. Higher levels of daily negative affect were also associated with elevated levels of bedtime cortisol, but only among older adults who, on average, reported lower levels of average negative affect. Findings support the theory of strength and vulnerability integration, and underscore the importance of age when examining associations between negative affective states and diurnal cortisol.
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Affiliation(s)
- Jennifer R Piazza
- Department of Human Development and Family Studies, Pennsylvania State University, USA.
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25
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Abstract
The impact of stress on health and disease is an important research topic in psychosomatic medicine. Because research on hypothalamic-pituitary-adrenal (HPA) axis regulation under controlled laboratory studies lacks ecological validity, it needs to be complemented by a research program that includes momentary ambulatory assessment. The measurement of salivary cortisol offers the possibility to trace the free steroid hormone concentrations in ambulant settings. Therefore, in this article, we first discuss the role of salivary cortisol in ambulatory monitoring. We start with a brief description of HPA axis regulation, and we then consider cortisol assessments in other organic materials, followed by a presentation of common salivary markers of HPA axis regulation suitable for ambulatory assessment. We further provide an overview on assessment designs and sources of variability within and between subjects (intervening variables), acknowledge the issue of (non)compliance, and address statistical aspects. We further give an overview of associations with psychosocial and health-related variables relevant for ambulatory assessment. Finally, we deal with preanalytical aspects of laboratory salivary cortisol analysis. The relative simplicity of salivary cortisol assessment protocols may lead to an overoptimistic view of the robustness of this method. We thus discuss several important issues related to the collection and storage of saliva samples and present empirical data on the stability of salivary cortisol measurements over time.
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26
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Stress and Human Biology. Hum Biol 2012. [DOI: 10.1002/9781118108062.ch10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register]
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27
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Good M, Albert JM, Arafah B, Anderson GC, Wotman S, Cong X, Lane D, Ahn S. Effects on postoperative salivary cortisol of relaxation/music and patient teaching about pain management. Biol Res Nurs 2012; 15:318-29. [PMID: 22472905 DOI: 10.1177/1099800411431301] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The physiological and psychological stress of surgery and postoperative pain can leave patients more susceptible to infection and complications. The present study was designed to determine whether two interventions, patient teaching (PT) for pain management and relaxation/music (RM), reduced cortisol levels, an indicator of stress, following abdominal surgery. Patients (18-75 years) were randomly assigned to receive PT, RM, a combination of the two, or usual care; the 205 patients with both pre- and posttest cortisol values were analyzed. A 2 × 2 factorial design was used to compare groups for PT effects and RM effects. Stress was measured by salivary cortisol before and after 20-min tests of the interventions in the morning and afternoon of postoperative Day 2. Saliva was stimulated with lemon juice and analyzed with high-sensitivity salivary cortisol enzyme immunoassay. Comparisons using analysis of covariance (ANCOVA), controlling for baseline levels, showed no PT effect or RM effect on cortisol in the morning or afternoon. Post hoc ANCOVA showed no significant effects when intervention groups were compared to the control group. Although in previous studies, RM reduced pain and music reduced cortisol on Day 1, in the present study the cortisol response to surgery was not attenuated by PT or RM on Day 2. The RM intervention can be used for pain but needs to be further tested for effects on plasma cortisol in abdominal surgery patients on their first postoperative day.
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Affiliation(s)
- Marion Good
- Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, OH 44106, USA.
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Lai JCL, Chong AML, Siu OT, Evans P, Chan CLW, Ho RTH. Social network characteristics and salivary cortisol in healthy older people. ScientificWorldJournal 2012; 2012:929067. [PMID: 22489206 PMCID: PMC3317671 DOI: 10.1100/2012/929067] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2011] [Accepted: 11/29/2011] [Indexed: 11/17/2022] Open
Abstract
Psychobiological research on aging in humans has been confounded by individual differences that have not been adequately characterized in the literature. This paper is an attempt to shed light on this issue by examining the impact of social network characteristics predictive of successful aging on salivary cortisol among 78 older Chinese people in Hong Kong. Eight salivary cortisol samples were collected each day for two consecutive days from immediately after awakening to 12 hours later. Two components of the cortisol diurnal cycle, response to awakening and diurnal decline, were examined in relation to social network characteristics including size, emotional support, and cultivation. ANOVAs with repeated measured were run to examine influences of the three social network characteristics on the cortisol awakening response and diurnal decline, with the effects of gender, age, socioeconomic status, and waking time controlled. Results indicated that those who spent more time and effort in developing and strengthening their social ties (i.e., those high in “cultivation”) exhibited a significantly greater rise in cortisol in the morning and a significantly steeper decline over the day, thus attesting to more effective activation and deactivation of the HPA axis. Network cultivation reflected a positive motivation to nurture social relationships more than the other two network characteristics. Its effect on cortisol might stem from the positivity underlying the motivation.
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Affiliation(s)
- Julian C L Lai
- Department of Applied Social Studies, City University of Hong Kong, Hong Kong.
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Nyberg CH. Diurnal cortisol rhythms in Tsimane' Amazonian foragers: new insights into ecological HPA axis research. Psychoneuroendocrinology 2012; 37:178-90. [PMID: 21719201 DOI: 10.1016/j.psyneuen.2011.06.002] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2010] [Revised: 05/12/2011] [Accepted: 06/01/2011] [Indexed: 01/08/2023]
Abstract
Although a growing body of research has documented important pathways by which the HPA axis mediates the interface between the psychosocial world and individual health, there is a paucity of data from nonwestern populations, particularly from those populations with distinct nutritional and infectious disease ecologies. The specific objectives of this study are: (1) to document variation in diurnal cortisol rhythms among the Tsimane', a remote population in the Bolivian Amazon, (2) to explore this variation by age and by gender, and (3) to compare diurnal rhythms from this study to other population based studies of cortisol conducted in industrialized nations. Salivary cortisol samples were collected twice daily, immediately upon waking and before bed, for three consecutive days from 303 participants (age 1.6-82 years, 1564 samples) in conjunction with the Tsimane' Amazonian Panel Study (TAPS). Cortisol rhythms showed strong age effects across the developmental span, with basal levels and slopes increasing into adulthood, although individuals older than 60 years demonstrated a precipitous flattening of the diurnal slope. Cortisol profiles were elevated in adult females compared to their age-matched male counterparts, and diurnal slopes, as well as mean cortisol concentrations among the Tsimane' were the lowest reported in any population based study of HPA axis function. Although the within-population variation in cortisol profiles was consistent with the established correlates of time of day, age, and sex, the between-population comparisons revealed dramatically lower levels of HPA activity among the Tsimane'. This study provides a benchmark against which to reference cortisol levels from industrialized populations, and expands the range of documented variation in HPA axis function in a nonwestern context.
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Affiliation(s)
- Colleen H Nyberg
- University of Massachusetts Boston, Department of Anthropology, 100 Morrissey Boulevard, Boston, MA 02125, USA.
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Dockray S, Steptoe A. Chronotype and diurnal cortisol profile in working women: differences between work and leisure days. Psychoneuroendocrinology 2011; 36:649-55. [PMID: 20950941 DOI: 10.1016/j.psyneuen.2010.09.008] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2009] [Revised: 09/15/2010] [Accepted: 09/16/2010] [Indexed: 10/18/2022]
Abstract
The influence of chronotype on the diurnal profile of salivary cortisol was examined in a sample of 187 healthy women: 21 evening chronotype, 24 morning chronotype and 142 intermediate chronotype. Saliva samples were collected at waking, 30 min post-awakening, at 1000 h, 1200 h, 1500 h, 1700 h and at bedtime on one work and one leisure day. Several components of the diurnal profile were examined including the cortisol awakening response, the total cortisol output and the diurnal profile on both the work and the leisure day, a significant main effect of time emerged (both p<0.01). After adjustment for age, smoking status, self-rated health, time of waking, and sleep problems, no effect of chronotype was evident for cortisol in the evening, the cortisol awakening response, or total cortisol output over the working day. However, on the leisure day, total cortisol output was greater in evening-types than intermediate or morning-types, after adjustment for covariates (p=0.029). The present data indicate that chronotype has a limited impact on the diurnal cortisol profile of healthy women, and may be somewhat impervious to individual preferences for morning or evening activity.
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Affiliation(s)
- Samantha Dockray
- Department of Epidemiology and Public Health, University College London, London, UK.
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Kovach CR, Woods DL, Logan BR, Raff H. Diurnal variation of cortisol in people with dementia: relationship to cognition and illness burden. Am J Alzheimers Dis Other Demen 2011; 26:145-50. [PMID: 21273205 PMCID: PMC3060946 DOI: 10.1177/1533317510397329] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Cortisol patterns in nursing home residents with dementia are described and examined in relation to cognition and comorbid illnesses. Saliva was sampled 4 times in a 24-hour period (week 1) and at the same times 1 week later (week 2). In general, cortisol levels decreased from morning to evening, with 50% exhibiting a negative slope. In contrast, 38% of the participants had a relatively flat cortisol diurnal rhythm, and 7% exhibited an afternoon increase. The cortisol pattern was consistent between weeks 1 and 2 for 39% with a negative slope, 13% with a flat profile, and for 2% with an afternoon increase pattern. Cortisol rhythm was not statistically significantly related to cognition or illness burden. While this study contributes to the understanding of differences in the diurnal pattern of cortisol for older adults with dementia, more research is needed to understand the etiology of the differences and the biological mechanisms involved.
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Aubry JM, Jermann F, Gex-Fabry M, Bockhorn L, Van der Linden M, Gervasoni N, Bertschy G, Rossier MF, Bondolfi G. The cortisol awakening response in patients remitted from depression. J Psychiatr Res 2010; 44:1199-204. [PMID: 20471032 DOI: 10.1016/j.jpsychires.2010.04.015] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2009] [Revised: 04/14/2010] [Accepted: 04/14/2010] [Indexed: 10/19/2022]
Abstract
An impressive number of data has been accumulated on dysfunctions of the hypothalamo-pituitary-adrenal (HPA) axis and cortisol hypersecretion in depression. To assess the dynamic HPA functioning, the cortisol awakening response (CAR) is an easily accessible and reliable approach. Some data suggest that elevated CAR in depressed patients has trait-like characteristics. Therefore we investigated whether patients in remission from a depressive episode have elevated CAR compared to control subjects. CAR of thirty-eight patients in remission from depression (11 men, 27 women, age range 24-66) and 52 control participants were analyzed (18 men, 34 women, age range 24-63). All patients had experienced ≥3 previous depressive episodes and were off psychotropic medication since at least 3 months. Saliva samples were collected only once, at home, either on weekend or weekday at 0, 15, 30, 45 and 60 min post-awakening. The area under the curve (AUC) above minimum cortisol concentration displayed large interindividual variability (6.4-fold in remitted patients and 8.1-fold in controls, based on 80% range). Investigation of possible variability factors showed that percent explained variance increased from 3.9% when group was considered alone to 8.8%, 12.3% and 19.2% after adjusting for significant effects of weekday vs. weekend, wake-up time and sleep duration, respectively. According to the latter model, AUC was estimated to be 51% higher in remitted patients than in controls (p = 0.007), while a 21% AUC decrease was associated with a 1-h longer sleep duration (p<0.001). In future studies, detection of between-group differences might benefit from adjusting for sleep duration and other possible confounders.
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Affiliation(s)
- Jean-Michel Aubry
- Department of Psychiatry, Geneva University Hospital, Bipolar Program, 6-8 rue du 31 Décembre, 1207 Geneva, Switzerland.
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Oginska H, Fafrowicz M, Golonka K, Marek T, Mojsa-Kaja J, Tucholska K. CHRONOTYPE, SLEEP LOSS, AND DIURNAL PATTERN OF SALIVARY CORTISOL IN A SIMULATED DAYLONG DRIVING. Chronobiol Int 2010; 27:959-74. [DOI: 10.3109/07420528.2010.489412] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Raison CL, Borisov AS, Woolwine BJ, Massung B, Vogt G, Miller AH. Interferon-alpha effects on diurnal hypothalamic-pituitary-adrenal axis activity: relationship with proinflammatory cytokines and behavior. Mol Psychiatry 2010; 15:535-47. [PMID: 18521089 PMCID: PMC3403676 DOI: 10.1038/mp.2008.58] [Citation(s) in RCA: 140] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Interferon (IFN)-alpha has been used to investigate pathways by which innate immune cytokines influence the brain and behavior. Accordingly, the impact of IFN-alpha on diurnal secretion of hypothalamic-pituitary-adrenal (HPA) axis hormones was assessed in 33 patients eligible for treatment with IFN-alpha plus ribavirin for hepatitis C. In addition, the relationship between IFN-alpha-induced HPA axis changes and proinflammatory cytokines and behavior was examined. Plasma ACTH and cortisol as well as tumor necrosis factor (TNF)-alpha, interleukin-6 and their soluble receptors, were measured hourly between 0900 and 2100 hours at baseline and following approximately 12 weeks of either no treatment (n=13) or treatment with IFN-alpha/ribavirin (n=20). Plasma IFN-alpha was also measured at each visit. Depression and fatigue were assessed using the Montgomery-Asberg depression rating scale and the multidimensional fatigue inventory. Compared to no treatment, IFN-alpha/ribavirin administration was associated with significant flattening of the diurnal ACTH and cortisol slope and increased evening plasma ACTH and cortisol concentrations. Flattening of the cortisol slope and increases in evening cortisol were correlated with increases in depression (r=0.38, P<0.05 and r=0.36, P<0.05, respectively) and fatigue (r=0.43, P<0.05 and r=0.49, P<0.01, respectively). No relationship was found between immune and HPA axis measures, although increases in plasma IFN-alpha, TNF-alpha and soluble TNF-alpha receptor2 were independently correlated with behavioral endpoints. These data indicate that chronic exposure to innate immune cytokines may contribute to the altered diurnal HPA axis activity and behavior found in medically ill individuals. However, given the lack of correlation between HPA axis and immune measures, the mechanism by which chronic cytokine exposure influences HPA axis function remains to be determined.
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Adam EK, Kumari M. Assessing salivary cortisol in large-scale, epidemiological research. Psychoneuroendocrinology 2009; 34:1423-36. [PMID: 19647372 DOI: 10.1016/j.psyneuen.2009.06.011] [Citation(s) in RCA: 628] [Impact Index Per Article: 41.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2008] [Revised: 06/01/2009] [Accepted: 06/17/2009] [Indexed: 10/20/2022]
Abstract
Salivary cortisol measures are increasingly being incorporated into large-scale, population-based, or epidemiological research, in which participants are selected to be representative of particular communities or populations of interest, and sample sizes are in the order of hundreds to tens of thousands of participants. These approaches to studying salivary cortisol provide important advantages but pose a set of challenges. The representative nature of sampling, and large samples sizes associated with population-based research offer high generalizability and power, and the ability to examine cortisol functioning in relation to: (a) a wide range of social environments; (b) a diverse array individuals and groups; and (c) a broad set of pre-disease and disease outcomes. The greater importance of high response rates (to maintain generalizability) and higher costs associated with this type of large-scale research, however, requires special adaptations of existing ambulatory cortisol protocols. These include: using the most efficient sample collection protocol possible that still adequately address the specific cortisol-related questions at hand, and ensuring the highest possible response and compliance rates among those individuals invited to participate. Examples of choices made, response rates obtained, and examples of results obtained from existing epidemiological cortisol studies are offered, as are suggestions for the modeling and interpretation of salivary cortisol data obtained in large-scale epidemiological research.
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Affiliation(s)
- Emma K Adam
- School of Education and Social Policy and Institute for Policy Research, Northwestern University, United States
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Associations between sociodemographic, sampling and health factors and various salivary cortisol indicators in a large sample without psychopathology. Psychoneuroendocrinology 2009; 34:1109-20. [PMID: 19515498 DOI: 10.1016/j.psyneuen.2009.04.024] [Citation(s) in RCA: 138] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2008] [Revised: 04/27/2009] [Accepted: 04/28/2009] [Indexed: 11/23/2022]
Abstract
BACKGROUND Cortisol levels are increasingly often assessed in large-scale psychosomatic research. Although determinants of different salivary cortisol indicators have been described, they have not yet been systematically studied within the same study with a large sample size. Sociodemographic, health and sampling-related determinants of salivary cortisol levels were examined in a sample without potential disturbances because of psychopathology. METHODS Using 491 respondents (mean age=43.0 years, 59.5% female) without lifetime psychiatric disorders from the Netherlands Study of Depression and Anxiety (NESDA), sociodemographic, sampling and health determinants of salivary cortisol levels were examined. Respondents collected seven salivary cortisol samples providing information about 1-h awakening cortisol, diurnal slope, evening cortisol and a dexamethasone (0.5mg) suppression test (DST). RESULTS Higher overall morning cortisol values were found for smokers, physically active persons, persons without cardiovascular disease, sampling on a working day or in a month with less daylight. In addition, the cortisol awakening response was significantly flattened for males, persons with cardiovascular disease, those with late awakening times and those with longer sleep duration. Diurnal slope was steeper in men, physically active persons, late awakeners, working persons, and season with less daylight. A higher evening cortisol level was associated with older age, smoking and season with more daylight. Cortisol suppression after dexamethasone ingestion was found to be less pronounced in smokers, less active persons and sampling on a weekday. CONCLUSION Sociodemographic variables (sex, age), sampling factors (awakening time, working day, sampling month, sleep duration) and health indicators (smoking, physical activity, cardiovascular disease) were shown to influence different features of salivary cortisol levels. Smoking had the most consistent effect on all cortisol variables. These factors should be considered in psychoneuroendocrinology research.
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Swim JK, Johnston K, Pearson NB. Daily Experiences With Heterosexism: Relations Between Heterosexist Hassles and Psychological Well-Being. JOURNAL OF SOCIAL AND CLINICAL PSYCHOLOGY 2009. [DOI: 10.1521/jscp.2009.28.5.597] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Kudielka BM, Bellingrath S, Hellhammer DH. Further support for higher salivary cortisol levels in "morning" compared to "evening" persons. J Psychosom Res 2007; 62:595-6. [PMID: 17467415 DOI: 10.1016/j.jpsychores.2007.03.016] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2007] [Revised: 02/05/2007] [Accepted: 03/01/2007] [Indexed: 10/23/2022]
Abstract
We analyzed free cortisol daytime levels in a "3-days-7-samples-a-day" protocol in relation to morningness in 112 middle-aged male and female adults derived from the first year of data of the Trier Teacher Stress Study using a one-item proxy for the assessment of chronotype. First, log-transformed cortisol levels were analyzed by a repeated-measures approach controlling for relevant covariates. Results yielded an almost significant main effect of morningness (P=.06). Subsequent within-day analyses, additionally controlling for awakening time, resulted in (marginally) significant main effects of morningness at Day 1 (P=.06) and Day 3 (P=.05) and a significant interaction of sample-by-morningness at Day 2 (P=.04). In sum, the present data seem to corroborate the idea of higher daytime cortisol levels in morning relative to evening types in a sample of healthy middle-aged male and female adults.
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Affiliation(s)
- Brigitte M Kudielka
- Department of Theoretical and Clinical Psychobiology, University of Trier, Trier, Germany.
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