Cortisol Stress Response Variability in Early Adolescence: Attachment, Affect and Sex

Novel Assessment of the Impact of Irritability on Physiological and Psychological Frustration Responses in Adolescents

OBJECTIVE

Irritability, typically defined as a proneness to anger, particularly in response to frustration, falls at the intersection of emotion and disruptive behavior. Despite well-defined translational models, there are few convergent findings regarding the pathophysiology of irritability. Most studies utilize computer-based tasks to examine neural responses to frustration, with little work examining stress-related responding to frustration in social contexts. The present study is the first to utilize the novel Frustration Social Stressor for Adolescents (FSS-A) to examine associations between adolescent irritability and psychological and physiological responses to frustration.

METHOD

The FSS-A was completed by a predominantly male, racially, ethnically, and socioeconomically diverse sample of 64 12- to 17-year-olds, who were originally recruited as children with varying levels of irritability. Current irritability was assessed using the Multidimensional Assessment Profiles-Temper Loss scale (MAP-TL-Youth). Adolescents rated state anger and anxiety before and after the FSS-A, and usable salivary cortisol data were collected from 43 participants.

RESULTS

Higher MAP-TL-Youth scores were associated with greater increases in anger during the FSS-A, but not increases in anxiety, or alterations in cortisol. Pre-task state anger negatively predicted the slope of the rise in cortisol observed in anticipation of the FSS-A.

CONCLUSIONS

Results provide support for unique associations between adolescent irritability and anger during, and in anticipation of, frustrating social interactions. Such findings lay a foundation for future work aimed at informing physiological models and intervention targets.

Hormonal and psychological influences on performance anxiety in adolescent female volleyball players: a multi-approach study

Background

The neuroendocrine system has important implications for affiliation behavior among humans and can be used to assess the correlation between social relationships, stress, and health. This can be influenced by social closeness; this aspect is the closeness towards another individual or a group of individuals such as a sports team. Sports performance anxiety is considered an unpleasant emotional reaction composed of physiological, cognitive, affective, and behavioral components. This motivates us to learn about the process that can influence the outcome of competition. Hormones and genetics would seem to influence outcome and performance. In this regard, many studies have focused on the exercise response as a function of ovarian hormones and it has been observed that progesterone is a hormone that plays a key role in reducing anxiety, and thus stress, in humans and other animals. On the other hand, high cortisol concentrations are known to contribute to increased anxiety levels. However, the salivary alpha-amylase (sAA) enzyme has been suggested as marker of acute stress than cortisol. Genetics also seem to influence anxiety and stress management as in the case of brain-derived neurotrophic factor (BDNF) and striatal dopamine transporter (DAT). Therefore, the study aims to investigate social closeness, as a measure of sports team cohesion that can influence athletes' performance results, and its ability to influence the secretion of hormones, such as progesterone and cortisol, that affect the management of sports anxiety while also taking into account genetic background during a volleyball match.

Methods

Twenty-six female volleyball players who volunteered participated in this study (mean ± SD: age, 12.07 ± 0.7 years), and played in the final of the provincial volleyball championship in Palermo. All girls were during the ovarian cycle, in detail between the follicular and early ovulatory phases.

Results

The results showed a significant decrease in salivary cortisol only in the winning group (p < 0.039). In fact, whilst in the latter the pre-match level was 7.7 ng/ml and then decreased to 4.5 ng/ml after the match, in the losers group change was not statistically significant (7.8 ng/ml vs 6.6 ng/ml pre- and post-match). As to the sAA concentration, the winning team showed a statistically significant variation between pre- and post-match than the losers (166.01 ± 250 U/ml vs 291.59 ± 241 U/ml) (p = 0.01).

Conclusion

Analyzing the results of the SAS-2 psychological test it is highlighted that, on average, the loser group was more anxious than the winning group, and this contributed to the final result. In conclusion, there is strong evidence supporting the state of the art that many factors can affect performance anxiety and thus the performance itself.

Responsive parental support buffers the link between chronic stress and cardiometabolic risk among adolescents

Youth exposed to chronic stress exhibit increased cardiometabolic risk which parental social support may attenuate. Notably, theories emphasize that support should be delivered responsively for it to exert buffering effects, but this has not been thoroughly tested empirically. This study examined whether timing of support is an important but unrecognized element of responsiveness during adolescence in buffering the link between chronic stress and cardiometabolic risk. Participants were 242 adolescents aged 15 years (63 % female, 38 % Black). Adolescents completed assessments of chronic stress (Life Stress Interview), and trained personnel collected anthropometric measures and blood samples to assess cardiometabolic risk (reflected in low-grade inflammation and metabolic syndrome). Adolescents also completed an eight-day diary assessment to report daily stressor exposure and parental support. Using the diary data, responsiveness of parental support was operationalized as the within-individual difference in parental support received on stressor (vs. non-stressor) days, such that increased parental support on stressor days reflected more timely support. Results suggest that responsive parental support buffered the link between chronic stress and cardiovascular risk. Specifically, chronic stress was associated with greater risk only when parental support was not temporally aligned with stress exposure, but this association was not observed among adolescents who received timely parental support. These findings shed light on why parental support may not always exert buffering effects during adolescence, highlighting the importance of taking a developmental approach to understanding protective effects.

Potential connection between positive frustration in family leisure time and the promotion of adolescent autonomy

Family relationships during leisure time in adolescence have the potential to promote positive development, particularly in terms of autonomy. However, the scientific literature that links specifically positive family leisure to the development of adolescent autonomy is scarce, and lower when analyzing the role of frustration in leisure time. Grounded in Self-Determination Theory (SDT) this article examines the potential relationship between positive frustration in family leisure time and the promotion of adolescent autonomy. For that purpose, the manuscript addresses four objectives to be discussed consecutively: (1) to delimit the concept of adolescent autonomy and point out the difficulty of parental support; (2) to explore positive frustration, a concept aligned with Csikszentmihalyi's theory of flow, as a construct that can promote socio-emotional development in adolescence; (3) to describe the components of family leisure; and (4) to understand how the experience of optimal frustration may be linked to the development of adolescent autonomy during family leisure time. From this central question, several additional inquiries emerge: the interplay of frustration and failure in adolescence, the importance of parents and adolescents spending quality time together, the enjoyment in structured family leisure time, the autonomy-supportive parenting in leisure time activities in relation to daily activities, the need to strengthen adolescent bonds developed in infancy, and the complexity of paternal and maternal autonomy granting.

Parent-Child Separation and Diurnal Cortisol Rhythms Among Left-Behind Adolescents: The Moderating Role of Sex

Prior research examining parent-child separation and the hypothalamic-pituitary-adrenal (HPA) axis functioning has primarily focused on separation due to parental divorce or loss or forced migration. Less clear is the impact of parental economic migration on adolescents' HPA axis functioning. The present study fills this gap by examining diurnal cortisol patterns among left-behind adolescents who experienced separation from their migrant parents. Participants were 293 Chinese adolescents (33.4% girls, 66.21% left-behind adolescents; M_age = 10.80 years old, SD = 0.82 years). Two-level multilevel modeling was conducted to examine the associations between parent-child separation experiences and diurnal cortisol patterns. Although no significant differences were found between left-behind adolescents and their non-left-behind peers, results revealed that left-behind adolescents who experienced parent-child separation at earlier ages had more blunted diurnal cortisol slopes (usually signaling poorer mental and physical health), compared to their counterparts who experienced separation at older ages. Left-behind adolescent girls who had more adverse separation experiences exhibited smaller waking cortisol and blunted diurnal slopes; these findings were not observed among left-behind adolescent boys. Observing the association between timing of parent-child separation and adolescents' diurnal cortisol and the moderating effects of child sex, this study contributes uniquely to the developmental science of left-behind adolescents' physiological health.

Vulnerability to anxiety differently predicts cortisol reactivity and state anxiety during a laboratory stressor in healthy girls and boys

BACKGROUND

Children diagnosed with anxiety disorders show altered cortisol and state anxiety reactivity to stressful situations. To date, it remains unclear whether these dysregulations emerge after the pathology or whether they are also detectable in healthy children. If the latter is true, this may provide insight into children's vulnerability to develop clinical anxiety. Various personality factors (anxiety sensitivity, intolerance of uncertainty, perseverative cognitions) increase youth's vulnerability to develop anxiety disorders. This study aimed to examine whether vulnerability to anxiety was associated with cortisol reactivity and state anxiety in healthy youth.

METHODS

114 children (8-12 y/o) were exposed to the Trier Social Stress Test for Children (TSST-C), where saliva samples were collected for cortisol quantification. State anxiety was assessed 20 min before and 10 min after the TSST-C using the state form of the State-Trait Anxiety Inventory for Children. Vulnerability to anxiety was assessed using a composite score of the Childhood Anxiety Sensitivity Index, Intolerance of Uncertainty Scale for Children, and Perseverative Thinking Questionnaire.

RESULTS

Higher vulnerability to anxiety was associated with enhanced cortisol reactivity in boys. Irrespective of vulnerability level, girls reported greater changes in state anxiety in response to the TSST.

LIMITATIONS

Given the correlational nature of this study, the directionality of the results remains to be elucidated.

CONCLUSIONS

These results indicate that endocrine patterns characterizing anxiety disorders are detectable in healthy boys who exhibit a high level of self-reported vulnerability to anxiety. These results could aid in the early identification of children at risk of developing anxiety disorders.

Origin of Sex-Biased Mental Disorders: Do Males and Females Experience Different Selective Regimes?

The origins of sex-biased differences in disease and health are of growing interest to both medical researchers and health professionals. Several major factors have been identified that affect sex differences in incidence of diseases and mental disorders. These are: sex chromosomes, sex hormones and female immunity, sexual selection and antagonistic evolution, and differential susceptibility of sexes to environmental factors. These factors work on different time scales and are not exclusive of each other. Recently, a combined Sexual Selection-Sex Hormones (SS-SH) Theory was presented as an evolutionary mechanism to explain sex-biased differences in diseases and mental disorders (Singh in J Mol Evol 89:195-213, 2021). In that paper disease prevalence trends were investigated, and non-sex-specific diseases were hypothesized to be more common in males than in females in general. They showed signs of exceptions to this trend with inflammatory diseases and stress-related mental disorders that were more common in females. We believe that the SS-SH theory requires the consideration of psycho-social stress (PSS) to explain the predominance of female-biased mental disorders and some other exceptions in their findings. Here we present a theory of sex-differential experience of PSS and provide quantitative support for the combined SS-SH-PSS Theory using age-standardized incidence rates (ASIRs) recording the levels of male- and female-bias in data obtained from different countries. The grand theory provides an evolutionary framework for explaining patterns of sex-biased trends in the prevalence of disease and health. Further exploration of women's vulnerability to social factors may help to facilitate new treatments for female-biased diseases.

The Frustration Social Stressor for Adolescents (FSS-A): A newly adapted psychosocial stressor

The role of stress on adolescents and its impact on development and mental health is of significant psychological concern. Previous research has investigated physiological changes, stressor characteristics and individual differences in stress responding. Experimental procedures that closely simulate naturally occurring psychosocial stressors have primarily been achievement-related (e.g., test taking, competitive tasks and psychomotor performance) and anxiety-provoking tasks (e.g., public speaking, improvisation and invasive medical-procedures) but few seek to elicit frustration. To address this gap, a new experimental procedure was developed and validated against the Trier Social Stress Test for Teens, with a Low Stress condition as a control. Conflict-related stressors, such as parent- and peer-related debates, have been found to be effective in provoking frustration in adolescents. The Frustration Social Stressor for Adolescents (FSS-A), a moderate frustration-provoking stressor involves a peer debate on a 'hot' topic, followed by a serial subtraction task with still-faced judges. The FSS-A procedure effectively elicited reliable and valid physiological (cortisol, heart rate) stress responses and was an effective stressor for both sexes. This new, stress protocol mirrors frustrating- and anxiety-provoking stressful situations that adolescents commonly encounter and affords a more detailed study of differential stress response patterns, increased understanding of adolescent stress, and potential for psychoeducational programming, such as directions for education and therapeutic intervention.

The Association between Disordered Eating Behavior and Body Image Biological Maturation and Levels of Adipocytokines in Preadolescent Girls: The Healthy Growth Study

During puberty, rapid, complex hormonal, physical and cognitive changes occur that affect body image and eating behavior. The aim of this cross-sectional study, a secondary analysis of data from the Greek Healthy Growth Study, was to explore associations of disordered eating behaviors and body image in 1206 10–12-year-old girls during pubertal maturation, with serum leptin and adiponectin levels, according to body mass index (BMI). Eating behavior and disordered eating were assessed with the Dutch Eating Behavior Questionnaire (DEBQ) and the Children Eating Attitudes Test Questionnaire (ChEAT), respectively. Associations of components of DEBQ and ChEAT with maturation according to Tanner Stage (TS) and levels of leptin and adiponectin were explored by univariate and multivariate regression analysis. Adiponectin levels in girls at TS 1 were positively associated with the “social pressure to eat” score of ChEAT. Leptin levels in girls at TS 4 were positively correlated with the “restraint eating” score of DEBQ, and the “dieting”, “body image” and “food awareness” scores of ChEAT. After adjustment for TS and BMI, only “body image” and leptin remained significant. Further research may shed light on how these hormonal changes affect eating behaviors at various pubertal stages, contributing to “TS-specific” preventive strategies for eating disorders in girls.

Academic stress in adolescent students of an islamic-based school: the correlation with parenting style and spirituality

Background

Adolescents are vulnerable to experiencing academic stress because of exams and their expectations about their careers. Proper parenting styles from parents can reduce students’ academic stress. Also, Islamic-based schools develop youth spirituality so it can reduce academic stress. This study aimed to identify the correlation of parenting styles and spirituality with academic stress in adolescent students of an Islamic-based school.

Design and Methods

The study was used descriptive correlative with a cross-sectional approach. Data was collected online started from April 3^rd to May 10^th, 2020, with 109 respondents of the 12^th-grade senior student at Islamic-based high school MAN Jakarta Timur. Respondents were selected by simple random sampling. This study used the Parental Care Style Questionnaire, the Spiritual Involvement and Beliefs Scale, and the Educational Stress Scale for Adolescents. Data were analysed using the Pearson correlation analysis (CI 95%).

Results

There was a significant negative correlation between the democratic parenting style and academic stress level (p=0.000). There was a negative correlation between spirituality level and academic stress level (p=0.000).

Conclusions

This study suggests the parents use the democratic parenting style by encouraging and giving comfort to their children to be open to their parents about academic problems. Islamic-based schools should carry out routine religious programs, such as reading the Qur'an every day before classes start.

Meta-analysis of the effectiveness of the Trier Social Stress Test in eliciting physiological stress responses in children and adolescents

The Trier Social Stress Test (TSST) is known to reliably induce physiological stress responses in adult samples. Less is known about its effectiveness to elicit these responses in youth samples. We performed a meta-analysis of stress responses to the TSST in youth participants. Fifty-seven studies were included representing 5026 youth participants. Results indicated that the TSST was effective at eliciting stress responses for salivary cortisol (sCort; effect size [ES] = 0.47, p = 0.006), heart rate (HR; ES = 0.89, p < 0.001), pre-ejection period (PEP; ES = -0.37, p < 0.001), heart rate variability (HRV; ES = -0.33, p = 0.028), and systolic blood pressure (ES = 1.17, p < 0.001), as well as negative affect (ES = 0.57, p = 0.004) and subjective anxiety (ES = 0.80, p = 0.004) in youth samples. Cardiac output (ES = 0.15, p = 0.164), respiratory sinus arrhythmia (ES = -0.10, p = 0.064), and diastolic blood pressure (ES = 2.36, p = 0.072) did not reach statistical significance. Overall, effect sizes for the TSST varied based on the physiological marker used. In addition, several physiological markers demonstrated variance in reactivity by youth age (sCort, HR, HRV, and PEP), gender (sCort), type of sample (i.e., clinical versus community sample; sCort and HR), duration of TSST (sCort, HR, HRV, negative affect, and subjective anxiety), number of judges present in TSST (HR and subjective anxiety), gender of judges (sCort), and time of day the marker was assessed (morning versus afternoon/evening; sCort). Overall, the findings provide support for the validity of the TSST as a psychosocial stressor for inducing physiological and psychological stress responses in children and adolescents, but also highlight that some markers may capture the stress response more effectively than others.

Human attachment triggers different social buffering mechanisms under high and low early life stress rearing

Social buffering - the attenuation of stress by maternal safety signals - is a core mammalian-general stress management mechanism implicating two ancient systems: the oxytocinergic and HPA systems. Yet, because human attachments are representation-based, understanding social buffering mechanisms in humans requires the assessment of relationship history and consideration of early life stress (ELS), which alters stress responsivity. We followed a unique trauma-exposed cohort across childhood, versus a low-stress control group, and repeatedly observed maternal sensitive, safety-promoting style. In adolescence, we used an attachment induction paradigm that exposed children to both live and reminders of attachment safety signals and measured oxytocin and cortisol baseline and response, to test how maternal safety signals impact hormonal reactivity in children reared under high- versus low-stress conditions. Only safety-promoting mothers exhibited a stress-buffering function, but their effect was system-specific and depended on the rearing context. For oxytocin, safety-promoting mothers normalized the deficient baseline oxytocin levels observed in ELS youth by implicating a plasticity-by-affiliation mechanism. For cortisol, safety-promoting mothering reduced the initial stress response only among youth reared in low-stress contexts via the typical buffering-by-safety mechanism. Results suggest that human attachments require internalized security evolving over time to trigger a stress buffering function. Under conditions of chronic early stress, the stressful rearing context overrides the maternal safety signals, normative stress buffering mechanisms fail, and safety-promoting mothers switch to an immature, affiliation-based mechanism that relies on maternal presence.

Neurobiological mechanisms underlying sex-related differences in stress-related disorders: Effects of neuroactive steroids on the hippocampus

Men and women differ in their vulnerability to a variety of stress-related illnesses, but the underlying neurobiological mechanisms are not well understood. This is likely due to a comparative dearth of neurobiological studies that assess male and female rodents at the same time, while human neuroimaging studies often don't model sex as a variable of interest. These sex differences are often attributed to the actions of sex hormones, i.e. estrogens, progestogens and androgens. In this review, we summarize the results on sex hormone actions in the hippocampus and seek to bridge the gap between animal models and findings in humans. However, while effects of sex hormones on the hippocampus are largely consistent in animals and humans, methodological differences challenge the comparability of animal and human studies on stress effects. We summarise our current understanding of the neurobiological mechanisms that underlie sex-related differences in behavior and discuss implications for stress-related illnesses.

Adolescent stress reactivity: Examining physiological, psychological and peer relationship measures with a group stress protocol in a school setting

INTRODUCTION

Adolescents experience enhanced social sensitivity and biopsychosocial changes that can be challenging. Much remains unknown about the effect of psychological characteristics and peer relationships on adolescents' physiological responses to stress, due in part to methodological limitations.

METHODS

To test how adolescents' peer relationships and psychological characteristics are associated with their physiological and psychological response to stress, we administered the Group Public Speaking Task for Adolescents (GPST-A) to 54 adolescents (n = 40 girls; Mage = 16.6 years) in two high schools in the United States. Salivary cortisol and alpha-amylase (sAA), and positive and negative affect were measured six times. Relationships among group members were measured, resulting in whole-network data. State and trait rumination, five factors of coping, and emotional reappraisal and suppression were measured along with symptoms of depression and anxiety.

RESULTS

Greater levels of negative evaluation and victimization among group members were associated with a steeper increase and decline in the negative affect response, yet not associated with the physiological response to stress. Greater positive affect was associated with decreased cortisol reactivity, whereas negative affect was associated with steeper cortisol and sAA reactivity. Rumination, disengagement coping, and depression symptoms were related to the physiological response to stress.

CONCLUSIONS

The GPST-A is feasible to administer in a school context with adolescents to collect both physiological and psychological stress responses. Findings from the present study suggest peer relationships are important for understanding adolescents' psychological response to stressors while psychological characteristics are important for adolescents' physiological response to stress.

Perceived stress and reference ranges of hair cortisol in healthy adolescents

Background

Chronic stress during adolescence has usually been evaluated through subjective measures, leaving aside objective measures such as hair cortisol concentrations. Therefore, the aim of this study was to provide reference ranges for hair cortisol concentrations by sex and age and to study the relationship between subjective and objective measures of stress and temporal stability.

Methods

The participants were 170 adolescents aged between 12 and 14 years (mean = 12.78 years; standard deviation = 0.71 years; 52.40% girls) who completed the Perceived Stress Scale 4 and had their hair sampled.

Results

The results revealed hair cortisol concentrations ranging from 0.07 pg/mg to 9.54 pg/mg. Subjective and objective measures of stress were not related, nor was there intraindividual stability of the hair cortisol concentrations. Girls had higher hair cortisol concentrations, and there were no age differences.

Conclusions

This research provides cortisol reference values for adolescents that will allow the early detection of chronic stress. Such detection methods make it possible to prevent problems arising from stress because we can act more quickly and the treatments will be more effective. The study suggests that there is no relationship between perceived and objective stress; while perceived stress remained stable, the levels of hair cortisol were increased at 6 months. Despite the interesting findings of the study, there are some limitations: the sample was not obtained through probabilistic sampling, the age range was narrow, and some demographic, anthropomorphic and clinical factors are missing, which make the generalization of results difficult.

Effects of preferred music therapy on peer attachment, depression, and salivary cortisol among early adolescents in Taiwan

AIMS

To explore the effects of preferred music therapy on peer attachment, depression, and salivary cortisol among early adolescents.

BACKGROUND

As adolescents enter puberty, they start to seek partnering relationships among peers. Peer attachment is central for adolescents and greatly influences their physical and psychological development.

DESIGN

A pre-test-posttest control group design.

METHODS

The data were collected from July - October 2016. A total of 65 individuals were included. The treatment group received 40 min of music therapy twice per week over the course of 10 weeks. The control group maintained its typical routine. The research data were collected using structured questionnaires, including basic information, the Inventory of Peer Attachment, the Beck Depression Inventory-II questionnaires, and salivary cortisol concentrations. Statistical analysis methods included percentages, chi-square tests, t tests, analyses of covariance, and the Johnson-Neyman technique.

RESULTS

There were statistically significant differences in peer attachment, depression, and salivary cortisol levels in the music group compared to the control group (p < 0.05). Additionally, the findings showed that early adolescents with more severe depression experienced greater improvement through preferred music therapy.

CONCLUSION

The results allude to the beneficial effects of receiving preferred music therapy in terms of the peer attachment, depression, and salivary cortisol levels of early adolescents. Adjustments should be made based on the characteristics of student groups to develop suitable and safe music therapy and to reduce the risks of poor mental health.

Early life stress, air pollution, inflammation, and disease: An integrative review and immunologic model of social-environmental adversity and lifespan health

Socially disadvantaged individuals are at greater risk for simultaneously being exposed to adverse social and environmental conditions. Although the mechanisms underlying joint effects remain unclear, one hypothesis is that toxic social and environmental exposures have synergistic effects on inflammatory processes that underlie the development of chronic diseases, including cardiovascular disease, diabetes, depression, and certain types of cancer. In the present review, we examine how exposure to two risk factors that commonly occur with social disadvantage-early life stress and air pollution-affect health. Specifically, we identify neuroimmunologic pathways that could link early life stress, inflammation, air pollution, and poor health, and use this information to propose an integrated, multi-level model that describes how these factors may interact and cause health disparity across individuals based on social disadvantage. This model highlights the importance of interdisciplinary research considering multiple exposures across domains and the potential for synergistic, cross-domain effects on health, and may help identify factors that could potentially be targeted to reduce disease risk and improve lifespan health.