Are salivary gonadal steroid concentrations influenced by acute psychosocial stress? A study using the Trier Social Stress Test (TSST)

Gonads under stress: A systematic review and meta-analysis on the effects of acute psychosocial stress on gonadal steroids secretion in humans

Animal research has shown that the hypothalamus-pituitary-gonadal (HPG) axis is inhibited by (chronic and/or severe) stress, which can lead to impaired fertility and reproductive functioning, presumably caused by the inhibition of gonadal steroid secretion and in interactions with glucocorticoids. However, what has not been clarified is how acute psychosocial stress modulates gonadal steroid secretion in humans. Here we summarize the experimental research on the acute effects of stress on the secretion of gonadal steroids in humans. A systematic literature search revealed 21 studies (with N=881 individuals) measuring testosterone, progesterone or estradiol in response to a standardized acute laboratory stressor in healthy humans. Both our literature review and quantitative meta-analysis suggest that in humans, acute stress stimulates rather than inhibits HPG axis activity, although there is a considerable heterogeneity in the reported methods and results. Increased gonadal steroids in response to acute stress contrasts with many animal studies reporting the opposite pattern, at least regarding severe and/or chronic stressors. We discuss methodological issues and challenges for future research and hope to stimulate experimental studies within this area. A better understanding of these mechanisms is needed, and may have important implications for health and disease, as well as the modulation of various behaviors by acute stressors.

Associations between Social Adversity and Biomarkers of Inflammation, Stress, and Aging in Children

BACKGROUND

Prior work has found relationships between childhood social adversity and biomarkers of stress, but knowledge gaps remain. To help address these gaps, we explored associations between social adversity and biomarkers of inflammation (interleukin-1β [IL-1β], IL-6, IL-8, tumor necrosis factor-alpha [TNF-α], and salivary cytokine hierarchical "clusters" based on the three interleukins), neuroendocrine function (cortisol, cortisone, dehydroepiandrosterone, testosterone, and progesterone), neuromodulation (N-arachidonoylethanolamine, stearoylethanolamine, oleoylethanolamide, and palmitoylethanolamide), and epigenetic aging (Pediatric-Buccal-Epigenetic clock).

METHODS

We collected biomarker samples of children ages 0-17 recruited from an acute care pediatrics clinic and examined their associations with caregiver-endorsed education, income, social risk factors, and cumulative adversity. We calculated regression-adjusted means for each biomarker and compared associations with social factors using Wald tests. We used logistic regression to predict being in the highest cytokine cluster based on social predictors.

RESULTS

Our final sample included 537 children but varied based on each biomarker. Cumulative social adversity was significantly associated with having higher levels of all inflammatory markers and with cortisol, displaying a U-shaped distribution. There were no significant relationships between cumulative social adversity and cortisone, neuromodulation biomarkers or epigenetic aging.

CONCLUSION

Our findings support prior work suggesting that social stress exposures contribute to increased inflammation in children.

IMPACT

Our study is one of the largest studies examining associations between childhood social adversity and biomarkers of inflammation, neuroendocrine function, neuromodulation, and epigenetic aging. It is one of the largest studies to link childhood social adversity to biomarkers of inflammation, and the first of which we are aware to link cumulative social adversity to cytokine clusters. It is also one of the largest studies to examine associations between steroids and epigenetic aging among children, and one of the only studies of which we are aware to examine associations between social adversity and endocannabinoids among children.

CLINICAL TRIAL REGISTRATION

NCT02746393.

Early life adversity is associated with attenuated testosterone reactivity to acute stress among adolescents

Understanding how testosterone responds to stress or challenge may be integral to uncovering biological pathways to potentially harmful behaviors like aggression. Yet, studies investigating patterns of testosterone reactivity under stress within adolescent populations are limited. Among those conducted, even fewer have investigated environmental factors which may shape such patterns. Exposure to early life adversity (ELA) has been shown to influence other biological markers of stress reactivity, though how it may be associated with alterations in testosterone reactivity remains underexplored. The current study addresses these gaps by examining salivary testosterone concentrations across the administration of a Trier Social Stress Test for Children in a sample of 87 adolescents (46.4% female, M_age = 13.91 years, SD_age = 1.57). The current study tested two central hypotheses: (1) that testosterone would rise in response to a standardized laboratory stressor, and (2) that greater ELA would be associated with higher baseline (or, pre-stress) testosterone scores and a dampened testosterone response to stress. Adolescents in the current sample showed a robust increase in testosterone following administration of the TSST-C, supporting the limited previous findings which indicate testosterone does mount an acute stress response in adolescents. Contrary to hypotheses, ELA was not associated with significant elevations in baseline testosterone scores. However, ELA was associated with dampened testosterone reactivity, even after controlling for important demographic and biological factors. Methodological implications, including considerations for researchers aiming to capture an acute testosterone response, as well as how our understanding of ELA's role in adolescent biological functioning is extended by our findings regarding testosterone, are discussed.

Salivary testosterone, testosterone/cortisol ratio and non-verbal behavior in stress

The relationship between hormone release and non-verbal communication under stress conditions is still not sufficiently explored. The aim of the present study was to test the hypothesis that salivary testosterone concentrations and testosterone/cortisol (T/C) ratios correlate positively with assertive behavior representing a non-aggressive form of dominance during an acute stress situation. As a stress model, a socially evaluated cold pressor test was investigated in healthy men. The non-verbal behavior was analyzed according to the ethological coding system for interviews described by Troisi (1999). Salivary testosterone concentrations did not change throughout the stress test. The T/C ratios decreased significantly over time only in subjects showing high stress perception. The duration of affiliative and the frequency of flight behavior was higher in subjects with high stress perception compared to those with low stress perception. A significant positive correlation between the duration of prosocial behavior and values of T/C ratios was found in the whole sample. The area under the curve values of testosterone positively correlated with the duration of assertive behavior in the group with high stress perception and negatively in the other group. Our findings allow suggesting that the changes in non-verbal behavior during acute psychosocial stress situations may be more pronounced in subjects showing high stress perception. Obtained results motivate further research on a better understanding of the consequences of the lack of sense of full facial expressions, such as wearing face masks, on the balance between hormones and non-verbal behavior under stress conditions.

Hormonal changes of intimate partner violence perpetrators in response to brief social contact with women

This study investigated whether men with a history of real‐life aggressive, dominant behavior show increases in testosterone and cortisol levels after brief social contact with women. Furthermore, we tested the prediction that such changes in hormones would be larger than those observed previously in young male students. Sixty‐seven male participants convicted of intimate partner violence (IPV) either had brief social contact with a female confederate (experimental condition) or a male confederate (control condition). We also performed meta‐analyses to investigate whether IPV perpetrators' hormonal responses were larger than the typical responses of young male students in prior studies. All statistical analyses were preregistered. Change in testosterone did not differ across experimental conditions, and testosterone in the IPV perpetrators actually declined from baseline in the female confederate condition. Our meta‐analysis showed that this testosterone decrease was different from the testosterone increase typically observed in young male students. The cortisol levels of IPV perpetrators did not change in response to contact with women. This result was consistent with our meta‐analysis since young male students also did not experience a cortisol change in response to interactions with women. In sum, our findings provide no evidence that male IPV perpetrators exhibit larger hormone increases to brief interactions with women, although it is possible that the men in this sample did not perceive the social contact period as a courtship opportunity. These results suggest that hormone reactivity to social encounters may differ across subject populations and depend on how subjects perceive social situations within laboratory settings.

The gonadal response to social stress and its relationship to cortisol

The cortisol response to social evaluative stress has been well characterized. However, data regarding changes in gonadal hormones after stress are still scarce and inconsistent. The majority of studies have focused on testosterone reactivity to stress in men, while estradiol responses or gonadal stress responses in women have hardly been investigated. Furthermore, it has not been evaluated whether sex hormone reactivity to stress differs between men and women and the relationship between cortisol and gonadal reactivity to stress is still unclear. To address these questions, we re-analyzed saliva samples collected from 37 men and 30 women in their luteal cycle phase before and repeatedly after social-evaluative stress. Both, testosterone and estradiol levels were assessed. In both men and women, testosterone was significantly reduced after stress. Testosterone levels were at their lowest after 20 minutes, but did not return to baseline until 35 minutes after stress. Across the whole sample, estradiol was significantly increased after stress with two separate peaks after 15 and 30 minutes. Follow-up analyses revealed that 41 participants actually responded with a decrease in estradiol levels to stress, with lowest levels after 20 min, while the remaining participants responded with an increase in estradiol levels. These gonadal stress responses appear to be largely independent of the cortisol response to stress. These results demonstrate that the endocrinological stress response is not restricted to the HPA axis and stress responsivity of gonadal hormones is not simply driven by cortisol. Accordingly, the stress responsivity of gonadal hormones and their association to psychological variables is an additional avenue to explore in both men and women.

Stress Reactivity to the Trier Social Stress Test in Traditional and Virtual Environments: A Meta-Analytic Comparison

OBJECTIVE

The traditional Trier Social Stress Test (TSST) is a widely used standardized stress induction protocol and has recently been adapted in a variety of virtual reality environments (V-TSST). Research has demonstrated the ability of the V-TSST to induce a stress reactivity response measured via cortisol, heart rate, and self-report. However, research comparing stress reactivity induced via the V-TSST to the traditional TSST across neuroendocrine, cardiovascular, and self-report variables has not yet been systematically and quantitatively reviewed.

METHODS

In this meta-analytic review, the existing studies that used V-TSST were gathered, and each was age and sex matched with samples using the traditional TSST. These studies were then meta-analytically synthesized to determine if there was a moderating effect of TSST type (traditional TSST or V-TSST) on multiple measures of stress reactivity (i.e., cortisol, heart rate, and self-report).

RESULTS

Examining the pre-post stress induction, the V-TSST studies demonstrated comparable effect sizes (ESs) for stress reactivity (cortisol ES = 0.61, heart rate ES = 0.98, self-reported stress ES = 0.94) to traditional TSST study ESs (cortisol ES = 0.79, heart rate ES = 0.85, self-reported stress ES = 0.85).

CONCLUSIONS

The TSST type differences between ESs were not statistically significant, indicating that the V-TSST is as effective as the traditional TSST at eliciting a physiological and self-reported stress reactivity response. Implications and limitations of this meta-analysis are discussed, and recommendations for future research are provided.

The effects of a music intervention during port catheter placement on anxiety and stress

Studies have shown that perioperative music interventions can reduce patients' anxiety levels. However, in small operations like port catheter surgery evidence is sparse. The present single-blinded, randomised controlled two-armed study included 84 female patients undergoing port catheter placement who were randomly assigned to either listening to music during surgery vs. no music intervention. The medical staff was blind to group allocation. On the day of the surgery anxiety and stress levels were evaluated using subjective (STAI questionnaire, visual analogue scales) and objective (vital parameters, salivary cortisol) parameters at different time points (before the surgery, at the end of the surgery and 1 h post-surgery). The music group showed significant reductions of systolic blood pressure (from 136.5 mmHg ± 26.1 to 123.3 mmHg ± 22.0, p = .002) and heart rate (from 75.6 bpm ± 12.3 to 73.1 bpm ± 12.2, p = .035) from beginning of the surgery to skin suture, whereas the control group did not. No significant effects of the music intervention on subjective anxiety measures or salivary cortisol were revealed. In sum, the study demonstrates that a music intervention during port catheter placement positively influences physiological anxiety levels, whereas no effects were revealed for subjective anxiety and salivary cortisol. Thus, music can be considered as a low cost addition in clinical routine in order to reduce patients' heart rate and blood pressure. Future studies are encouraged to further explore the differential effects of intraoperative music interventions on physiological, endocrinological and subjective anxiety levels.

A systematic review and meta-analysis of the effect of emotion regulation on cortisol

It is generally acknowledged that hormones are implicated in socioemotional behavior, yet little is known about the role of hormones in the context of emotion regulation. The aims of the present review and meta-analysis were to review and synthesize the available evidence pertaining to the effect of emotion regulation instructions on hormones, and to investigate whether this effect varies according to: type of hormone, context (e.g., emotion-induction procedure), emotion regulation characteristics (e.g., emotion regulation strategy), and presence and type of psychiatric disorder. PubMed, PsycINFO, and CINAHL were searched for experimental studies assessing the effect of instructed emotion regulation on levels of hormones (i.e., testosterone, cortisol, oxytocin, estradiol, and vasopressin) in physically healthy adults. The literature search yielded 17 relevant studies, 16 investigating cortisol and one investigating testosterone. Of these, 12 cortisol studies had eligible data for the meta-analysis. The results of the meta-analysis indicated no statistically significant effect of receiving an emotion regulation instruction compared with receiving no instruction on the cortisol response to subsequent emotion induction (g ​= ​−0.05, p ​= ​.48). However, within-person comparisons of change from an unregulated response to a regulated response indicated a significant change in cortisol levels (g ​= ​0.18, p ​= ​.03) consistent with the specified regulation goal (i.e., either up- or downregulation). No statistically significant effects were found in subgroup meta-analyses conducted according to context, emotion regulation characteristics or psychiatric disorders. Taken together, the findings indicate that emotion-induction procedures are associated with increases in cortisol that may subsequently return to equilibrium regardless of emotion-regulation instructions. Based on the large gaps in research (e.g., few studies investigated other hormones than cortisol, few studies included self-report measures of emotions) identified in the present review, we conclude that the effect of emotion regulation on hormones remains poorly understood.

Prospero registration

CRD42020157336.

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Research on the effect of emotion regulation on hormones has focused on cortisol.

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Emotion regulation does not influence cortisol responses to emotion induction.

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Psychological confounders have received little attention in the reviewed research.

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The effect of emotion regulation on hormones remains poorly understood.

Psychosocial stress increases testosterone in patients with borderline personality disorder, post-traumatic stress disorder and healthy participants

BACKGROUND

The gonadal hormone testosterone not only regulates sexual behavior but is also involved in social behavior and cognition in both sexes. Changes in testosterone secretion in response to stress have been reported. In addition, stress associated mental disorders such as borderline personality disorder (BPD) and posttraumatic stress disorder (PTSD) are characterized by alterations in basal testosterone metabolism. However, testosterone changes to stress have not been investigated in mental disorders such as BPD and PTSD so far.

METHODS

In the study described, we investigated testosterone reactivity to an acute psychosocial stressor, the Trier Social Stress Test (TSST). Our sample consisted of young adult women with BPD (n = 28), PTSD (n = 22) or both disorders (n = 22), and healthy control (n = 51). Based on previous studies on basal testosterone secretion in these disorders, we expected the stress-associated testosterone reactivity to be higher in the BPD group and lower in the PTSD group, when compared to the healthy control group.

RESULTS

The study could demonstrate an increase in testosterone after acute stress exposure across all groups and independent of BPD or PTSD status. Different possible explanations for the absence of a group effect are discussed.

CONCLUSIONS

From the results of this study, we conclude that stress-related changes in testosterone release are not affected by BPD or PTSD status in a female patient population. This study expands the knowledge about changes in gonadal hormones and stress reactivity in these disorders.

The acute effect of psychosocial stress on the level of oxidative stress in children

The effect of chronic stress on oxidative stress (OS) is commonly discussed while the effect of acute stress situation is not fully examined yet. The present study was aimed to analyse whether acute psychosocial strain causes changes in OS and antioxidant status. Unstimulated saliva was collected from 46 healthy prepubertal children during the control and stress day. On the stress day, collection was performed before and after a stress situation induced by the Trier social stress test. Saliva collection during the control day imitated the stress day without the stress strain. Samples were used for analysis of lipid peroxidation, thiobarbituric acid reactive substances (TBARS), advanced glycation end products (AGEs) and markers of antioxidant status, total antioxidant capacity (TAC) and ferric reducing antioxidant power (FRAP). On the stress day, increased level of FRAP was observed in the second saliva collection in comparison with the first collection. Within the same day, no significant changes in the levels of TBARS, AGEs and TAC were observed in samples taken before and after stress strain. Significantly higher levels of TBARS were observed on stress day in comparison to control day. In summary, acute psychosocial stress caused increase of FRAP during the stress day. TBARS did not increase during the stress day in the second sample but it was higher compared to the control day. None of the interactions with gender were statistically significant. It appears the short-term exposure to stress could potentially stimulate antioxidant activity.

Post-Encoding Stress Does Not Enhance Memory Consolidation: The Role of Cortisol and Testosterone Reactivity

In contrast to the large body of research on the effects of stress-induced cortisol on memory consolidation in young people, far less attention has been devoted to understanding the effects of stress-induced testosterone on this memory phase. This study examined the psychobiological (i.e., anxiety, cortisol, and testosterone) response to the Maastricht Acute Stress Test and its impact on free recall and recognition for emotional and neutral material. Thirty-seven healthy young men and women were exposed to a stress (MAST) or control task post-encoding, and 24 h later, they had to recall the material previously learned. Results indicated that the MAST increased anxiety and cortisol levels, but it did not significantly change the testosterone levels. Post-encoding MAST did not affect memory consolidation for emotional and neutral pictures. Interestingly, however, cortisol reactivity was negatively related to free recall for negative low-arousal pictures, whereas testosterone reactivity was positively related to free recall for negative-high arousal and total pictures. This study provides preliminary evidence about a different reactivity of testosterone and cortisol to the MAST as well as on their effects on consolidation. Our results suggest a different pattern of relationships between these steroid hormones and the arousal of the negative images.

The effects of a music and singing intervention during pregnancy on maternal well-being and mother-infant bonding: a randomised, controlled study

Purpose

Stress and impaired mother–infant bonding during pregnancy can lead to adverse effects for the expectant mother and the unborn child. The present study investigates whether a prenatal music and singing intervention can improve maternal well-being as well as mother–infant bonding.

Methods

A total of 172 pregnant women took part in this prospective, randomised, three-armed (music, singing or control group) study. Depressive symptoms, self-efficacy, maternal well-being and mother–infant bonding were assessed with visual analogue scales and questionnaires before the intervention phase (30th week of gestation) and afterwards (36th week of gestation). Additionally, immediate changes regarding experienced stress and mood from before until after the music and singing interventions were explored with questionnaires as well as saliva samples (for cortisol, alpha-amylase and oxytocin determination).

Results

Regarding immediate effects, both interventions showed positive effects on the emotional state, stress (cortisol) and bonding (oxytocin). Additionally, the singing group showed a larger reduction in cortisol and a larger improvement in valence than the music group. Looking at more prolonged effects, significant effects on general self-efficacy and perceived closeness to the unborn child (measured with a visual analogue scale) were found. No significant effects were revealed for the mother–infant bonding questionnaire and for depressive symptoms.

Conclusion

In the present study, promising effects of music and in particular singing on maternal well-being and perceived closeness during pregnancy appeared. Prenatal music and singing interventions could be an easy to implement and effective addition to improve mood and well-being of the expectant mother and support mother-infant bonding.

Trial registration number

DRKS00012822, date of registration: 17.10.2017

Electronic supplementary material

The online version of this article (10.1007/s00404-020-05727-8) contains supplementary material, which is available to authorized users.

The effects of testosterone on the physiological response to social and somatic stressors

Higher testosterone levels in males have previously been linked to decreased stress reactivity, but in other cases, testosterone has been reported to increase the stress response. We addressed these inconsistencies in a placebo-controlled single-dose testosterone administration study, in which 120 male participants were randomly assigned to undergo a cold-pressor test (CPT, a non-social somatic stressor), a socially evaluated cold-pressor test (SECPT, a social-somatic stressor), or a lukewarm water test (LWT, a non-stressful control condition). Throughout the experiment, blood pressure and interbeat intervals were measured continuously, and saliva samples for hormonal analyses were taken repeatedly at predefined time points. When comparing the groups treated with placebo, the SECPT elicited a larger increase in the systolic blood pressure than CPT, in agreement with previous studies. However, testosterone administration altered this pattern. Compared to placebo, testosterone increased systolic blood pressure during the CPT, whereas the opposite effect was found during the SECPT. Cortisol reactivity was not affected by testosterone administration. The CAG repeat polymorphism of the androgen receptor gene was unrelated to the effects of testosterone on the stress response, but it was correlated with blood pressure across the whole sample. Our findings demonstrate that testosterone's effects on the stress response are dependent on the social context. Testosterone's ability to flexibly influence the response to stressors may be an important mechanism through which the hormone promotes adaptive behavior. Our results are also in line with research showing that testosterone decreases social anxiety and suggest it may help to modulate the effects of stress in socially challenging situations.

The Association Between Experimentally Induced Stress, Performance Monitoring, and Response Inhibition: An Event-Related Potential (ERP) Analysis

Psychological stress is increasingly associated with alterations in performance and affect. Yet, the relationship between experimentally induced psychological stress and neural indices of performance monitoring and error processing, as well as response inhibition, are unclear. Using scalp-recorded event-related potentials (ERPs), we tested the relationship between experimental stress, using the Trier Social Stress Test (TSST), and the error-related negativity (ERN), error positivity (Pe), and N2 ERP components. A final sample of 71 undergraduate students were randomly assigned to go through the TSST (n = 36; 18 female) or a brief mindfulness relaxation exercise (n = 35; 16 female) immediately followed by a go/no-go task while electroencephalogram (EEG) data were collected. Salivary cortisol, heart rate, and blood pressure confirmed increased physiological stress in the TSST group relative to control. Reaction times, accuracy, and post-error slowing did not differ by stress group. Two-group (TSST, control) by 2-trial type (correct, incorrect for ERN/Pe; go correct, no-go correct for N2) repeated measures ANOVAs for the ERN, Pe, and N2 showed the expected main effects of trial type; neither the ERN nor the N2 ERP components showed interactions with the stress manipulation. In contrast, the Pe component showed a significant Group by Trial interaction, with reduced Pe amplitude following the stress condition relative to control. Pe amplitude did not, however, correlate with cortisol reactivity. Findings suggest a reduction in Pe amplitude following experimental stress that may be associated with reduced error awareness or attention to errors following the TSST. Given the variability in the extant literature on the relationship between experimentally induced stress and neurophysiological reflections of performance monitoring, we provide another point of data and conclude that better understanding of moderating variables is needed followed by high-powered replication studies to get at the nuance that is not yet understood in the relationship between induced stress and performance monitoring/response inhibition processes.

Hormones in speed-dating: The role of testosterone and cortisol in attraction

There is evidence that testosterone and cortisol levels are related to the attraction of a romantic partner; testosterone levels relate to a wide range of sexual behaviors and cortisol is a crucial component in the response to stress. To investigate this, we conducted a speed-dating study among heterosexual singles. We measured salivary testosterone and cortisol changes in men and women (n = 79) when they participated in a romantic condition (meeting opposite-sex others, i.e., potential romantic partners), as well as a control condition (meeting same-sex others, i.e., potential friends). Over the course of the romantic speed-dating event, results showed that women's but not men's testosterone levels increased and cortisol levels decreased for both men and women. These findings indicate that men's testosterone and cortisol levels were elevated in anticipation of the event, whereas for women, this appears to only be the case for cortisol. Concerning the relationship between attraction and hormonal change, four important findings can be distinguished. First, men were more popular when they arrived at the romantic speed-dating event with elevated cortisol levels. Second, in both men and women, a larger change in cortisol levels during romantic speed-dating was related to more selectivity. Third, testosterone alone was unrelated to any romantic speed-dating outcome (selectivity or popularity). However, fourth, women who arrived at the romantic speed-dating event with higher testosterone levels were more selective when their anticipatory cortisol response was low. Overall, our findings suggest that changes in the hormone cortisol may be stronger associated with the attraction of a romantic partner than testosterone.

A Functional Near-Infrared Spectroscopy Study on the Cortical Haemodynamic Responses During the Maastricht Acute Stress Test

In order to better understand stress responses, neuroimaging studies have investigated the underlying neural correlates of stress. Amongst other brain regions, they highlight the involvement of the prefrontal cortex. The aim of the present study was to explore haemodynamic changes in the prefrontal cortex during the Maastricht Acute Stress Test (MAST) using mobile functional Near-Infrared Spectroscopy (fNIRS), examining the stress response in an ecological environment. The MAST includes a challenging mental arithmic task and a physically stressful ice-water task. In a between-subject design, participants either performed the MAST or a non-stress control condition. FNIRS data were recorded throughout the test. Additionally, subjective stress ratings, heart rate and salivary cortisol were evaluated, confirming a successful stress induction. The fNIRS data indicated significantly increased neural activity of brain regions of the dorsolateral prefrontal cortex (dlPFC) and the orbitofrontal cortex (OFC) in response to the MAST, compared to the control condition. Furthermore, the mental arithmetic task indicated an increase in neural activity in brain regions of the dlPFC and OFC; whereas the physically stressful hand immersion task indicated a lateral decrease of neural activity in the left dlPFC. The study highlights the potential use of mobile fNIRS in clinical and applied (stress) research.

Comparing the course of anxiety in women receiving their first or repeated caesarean section: A prospective cohort study

BACKGROUND

Around 30% of births are through caesarean section and repetition rates for receiving a caesarean section are high.

AIM

The aim of the prospective study was to compare the course of anxiety in women undergoing their first caesarean section and women experiencing a repeated caesarean section.

PARTICIPANTS

304 women with an indication for an elective caesarean section took part. 155 received their first caesarean section and 149 received a repeated caesarean section.

METHODS

In order to measure the course of anxiety on the day of the caesarean section subjective anxiety levels were measured and saliva samples for cortisol determination were taken at admission, during skin closure and two hours after the surgery. Blood pressure and heart rate were documented at skin incision and skin closure.

RESULTS

Women experiencing their first caesarean section displayed significantly higher anxiety levels compared to women with a repeated caesarean section. Scores of the STAI-State and visual analogue scale for anxiety differed significantly at admission (p=.006 and p<.001) and heart rate and alpha amylase levels were significantly higher at skin closure (p=.027 and p=.029).

CONCLUSION

The results show that previous experience with a caesarean section has a soothing effect. The study aims to sensitize surgeons, anesthetists, nurses and midwives when treating women receiving a caesarean section and encourage them to incorporate soothing interventions, especially for women receiving their first caesarean section to reduce anxiety levels and consequently improve postoperative recovery and patients' satisfaction.

Effects of psychosocial stress on the hormonal and affective response in children with dyslexia

INTRODUCTION

Research on stress and dyslexia has mainly focused on chronic and contextual stress caused by the school environment. Our goal was to test individual differences in the hypothalamic-pituitary-adrenal (HPA) axis reactivity of dyslexic and non-dyslexic children and the related emotional manifestations associated with exposure to a psychosocial stressor.

METHODS

Eighty-one children (11-14 years old; 38 dyslexic) were exposed to the Trier Social Stress Test adapted to children or to a control condition. The salivary cortisol response, anxiety, and mood were measured before and after the stress.

RESULTS

Dyslexic children did not show the expected cortisol response, as the highest percentage of children who were non-reactive to stress was found in this group. Cortisol reactivity to stress was related to higher levels of anxiety and lower positive affect in the non-dyslexic children.

CONCLUSION

These results suggest a pattern of hypo-activation of the HPA axis to psychosocial stress in children with dyslexia.

Effects of hormonal contraceptive phase and progestin generation on stress-induced cortisol and progesterone release

The stress response differs between women using hormonal contraception and naturally cycling women. Yet, despite ample evidence showing that the stress response differs across the menstrual cycle in naturally cycling women, limited work has investigated whether the stress response differs across the hormonal contraceptive cycle, during which synthetic hormones are taken most of the month but not all of it. To induce a stress response, women using hormonal contraception completed the cold pressor test during either the active phase, when hormones are present, or during the inactive phase, when hormones are not present. Saliva was collected and assayed for free cortisol and progesterone levels prior to stress onset, immediately after stress termination, and 15-min post stress onset. Free cortisol and progesterone increased to a similar degree across both hormonal contraceptive phases in response to the cold pressor test. Post-hoc investigation indicates that the progestin “generation” (classification of synthetic progestins based on the compounds they are derived from) can differentially affect the free steroid response to cold pressor test stress, with the largest effects observed in women using formulations containing second-generation progestins. These findings indicate that progestin generation, particularly second-generation progestins, may have a more impactful influence on the stress response than hormonal contraceptive cycle phase. Potential mechanisms driving this effect and need for additional research are discussed.

Effects of sex and menstrual cycle phase on cardiac response and alpha- amylase levels in psychosocial stress

The impact of sex and the menstrual cycle phase on the autonomic response to psychosocial stress remains controversial. This study explored autonomic nervous system activity through salivary alpha-amylase, heart rate, and heart rate variability responses to the Trier Social Stress Test (TSST) in healthy young people. The sample was composed of 25 men, 26 women in the luteal phase, and 25 women in the follicular phase, from 18 to 25 years of age. Participants were exposed to the TSST or a control condition. The results indicate that women in their follicular phase showed a blunted alpha-amylase response to stress compared to men and women in the luteal phase. In addition, men showed higher sympatho-vagal activity in the stress condition compared to the two groups of women. These results confirm that sex and the menstrual cycle phase are potential modulators of autonomic nervous system reactivity to psychosocial stress.

Effects of music intervention during caesarean delivery on anxiety and stress of the mother a controlled, randomised study

Background

Stress and anxiety during pregnancy and childbirth have negative consequences for both mother and child. There are indications that music has a positive effect in this situation. The present study investigates the influence of music during the caesarean on anxiety and stress of the expectant mother.

Methods

The SAMBA study is a single-centre, controlled, randomized study including 304 patients. Women in the intervention group heard music via loudspeakers from one of four self-selected genres. The control group had standard treatment without music. The caesarean was performed in regional Anesthesia. At admission, at skin incision, during skin suture and two hours after completion of surgery, different subjective (State-Trait Anxiety Inventory, visual analogue scale for anxiety) and objective parameters (salivary cortisol/amylase, heart rate, blood pressure) were collected. Mixed-factorial Analysis of variances as well as independent sample t-tests were applied for data analysis.

Results

At skin suture, significantly lower anxiety levels were reported in the intervention group regarding State anxiety (31.56 vs. 34.41; p = .004) and visual analogue scale for anxiety (1.27 vs. 1.76; p = .018). Two hours after surgery, the measured visual analogue scale for anxiety score in the intervention group was still significantly lower (0.69 vs. 1.04; p = .018). The objective parameters showed significant differences between the groups in salivary cortisol increase from admission to skin suture (12.29 vs. 16.61 nmol/L; p = .043), as well as systolic blood pressure (130.11 vs. 136.19 mmHg; p = .002) and heart rate (88.40 vs. 92.57/min; p = .049) at skin incision.

Conclusions

Music during caesarean is an easy implementable and effective way of reducing stress and anxiety of the expectant mother.

Trial registration

German registry for clinical trials (DRKS00007840). Registered 16/06/2015. Retrospectively registered.

Gender differences in the psychophysiological effects induced by VOCs emitted from Japanese cedar (Cryptomeria japonica)

Background

Wood is a valuable material for interiors, and the psychophysiological relaxation effects of volatile organic compounds (VOCs) from wood chips and essential oils have been reported. However, few studies have identified the odors in full-scale wooden environment, and also, differences in gender have not been clarified. In this study, we aimed to confirm the effects of VOCs emitted from interior wood walls in both human male and female participants.

Methods

We used Japanese cedar timber and analyzed VOCs in the experimental rooms with and without Japanese cedar timber by gas chromatography-mass spectrometry (GC-MS). The physiological effects were measured using neuroendocrinological and immunological parameters in saliva. A questionnaire was used to evaluate the subjective responses to each odor in the experimental rooms.

Results

The main compound emitted from Japanese cedar timber was δ-cadinene, and the total volume of VOCs in the wood condition (presence of VOCs emitted from Japanese cedar) was 282.4 (μg/m³). Significant differences between genders in salivary parameters were shown that there were decreases of α-amylase in wood condition and increases of cortisol in the control (absence of VOCs) condition in female participants compared to male participants. The results demonstrated that VOCs in the experimental room with Japanese cedar timber tend to suppress the activation of the sympathetic nervous activity and non-VOCs of Japanese cedar in the control room increase cortisol in female participants.

Conclusions

These results suggest that an indoor environment with wood interior materials has the potential to be useful for health management, especially women’s health.

Maternal Exposure to Childhood Abuse is Associated with Mate Selection: Implications for Autism in Offspring

Maternal experience of childhood abuse has been associated with offspring autism. To explore whether familial tendency towards autistic traits-presumably related to genetic predisposition-accounts for this association, we examined whether women who experienced childhood abuse were more likely to select mates with high levels of autistic traits, and whether parental autistic traits accounted for the association of maternal abuse and offspring autism in 209 autism cases and 833 controls. Maternal childhood abuse was strongly associated with high paternal autistic traits (severe abuse, OR = 3.98, 95% CI = 1.26, 8.31). Maternal and paternal autistic traits accounted for 21% of the association between maternal abuse and offspring autism. These results provide evidence that childhood abuse affects mate selection, with implications for offspring health.

Impact of self-esteem and sex on stress reactions

Positive self-evaluation is a major psychological resource modulating stress coping behavior. Sex differences have been reported in self-esteem as well as stress reactions, but so far their interactions have not been investigated. Therefore, we investigated sex-specific associations of self-esteem and stress reaction on behavioral, hormonal and neural levels. We applied a commonly used fMRI-stress task in 80 healthy participants. Men compared to women showed higher activation during stress in hippocampus, precuneus, superior temporal gyrus (STG) and insula. Furthermore, men outperformed women in the stress task and had higher cortisol and testosterone levels than women after stress. Self-esteem had an impact on precuneus, insula and STG activation during stress across the whole group. During stress, men recruit regions associated with emotion and stress regulation, self-referential processing and cognitive control more strongly than women. Self-esteem affects stress processing, however in a sex-independent fashion: participants with lower self-esteem show higher activation of regions involved in emotion and stress regulation, self-referential processing and cognitive control. Taken together, our data suggest that men are more engaged during the applied stress task. Across women and men, lower self-esteem increases the effort in emotion and stress processing and cognitive control, possibly leading to self-related thoughts in stressful situations.

Social evaluative threat with verbal performance feedback alters neuroendocrine response to stress

Laboratory stress tasks such as the Trier Social Stress Test (TSST) have provided a key piece to the puzzle for how psychosocial stress impacts the hypothalamic-pituitary-adrenal axis, other stress-responsive biomarkers, and ultimately wellbeing. These tasks are thought to work through biopsychosocial processes, specifically social evaluative threat and the uncontrollability heighten situational demands. The present study integrated an experimental modification to the design of the TSST to probe whether additional social evaluative threat, via negative verbal feedback about speech performance, can further alter stress reactivity in 63 men and women. This TSST study confirmed previous findings related to stress reactivity and stress recovery but extended this literature in several ways. First, we showed that additional social evaluative threat components, mid-task following the speech portion of the TSST, were still capable of enhancing the psychosocial stressor. Second, we considered stress-reactive hormones beyond cortisol to include dehydroepiandrosterone (DHEA) and testosterone, and found these hormones were also stress-responsive, and their release was coupled with one another. Third, we explored whether gain- and loss-framing incentive instructions, meant to influence performance motivation by enhancing the personal relevance of task performance, impacted hormonal reactivity. Results showed that each hormone was stress reactive and further had different responses to the modified TSST compared to the original TSST. Beyond the utility of showing how the TSST can be modified with heightened social evaluative threat and incentive-framing instructions, this study informs about how these three stress-responsive hormones have differential responses to the demands of a challenge and a stressor.

La escucha de música antes del TSST regula los niveles de cortisol en saliva independiente de la preferencia musical

El presente estudio evaluó si la escucha de música preferida por los participantes o la música relajante elegida por los investigadores previa al protocolo de estrés social modificado TSST (Trier Social Stress Test) afectaba el desempeño de las actividades realizadas durante el propio test, modulaba la respuesta de estrés que este induce, y en conjunto con el estresor, afectaba el desempeño en una tarea de atención en setenta y seis estudiantes universitarios asignados a uno de seis grupos: música relajante del investigador, música preferida por el participante y silencio, con o sin TSST. Los resultados mostraron que la escucha de ambos tipos de música provocó un incremento más lento en los niveles de cortisol en saliva luego del TSST, mientras que el aumento en la ansiedad estado evaluada con el IDARE (Inventario de Ansiedad Rasgo-Estado) fue semejante en todos los grupos. No se encontraron diferencias debidas a la música en el desempeño de las tareas evaluadas. Se discute sobre la modulación de la escucha de música en la respuesta fisiológica de estrés por la posible inducción de reacciones emocionales de manera independiente de la preferencia musical.

Gonads and strife: Sex hormones vary according to sexual orientation for women and stress indices for both sexes

This study assessed sexual orientation and psychobiological stress indices in relation to salivary sex hormones as part of a well-validated laboratory-based stress paradigm. Participants included 87 healthy adults that were on average 25 years old who self-identified as lesbian/bisexual women (n=20), heterosexual women (n=21), gay/bisexual men (n=26), and heterosexual men (n=20). Two saliva samples were collected fifteen minutes before and fifteen minutes after exposure to a modified Trier Social Stress Test to determine testosterone, estradiol, and progesterone concentrations via enzyme-immune assaying. Mean sex hormones were further tested in association to stress indices related to cortisol systemic output (area under the curve with respect to ground) based on ten measures throughout the two-hour visit, allostatic load indexed using 21 biomarkers, and perceived stress assessed using a well-validated questionnaire. Results revealed that lesbian/bisexual women had higher overall testosterone and progesterone concentrations than heterosexual women, while no differences were found among gay/bisexual men in comparison to heterosexual men. Lesbian/bisexual women and heterosexual men showed positive associations between mean estradiol concentrations and allostatic load, while gay/bisexual men and heterosexual women showed positive associations between mean testosterone and cortisol systemic output. In summary, sex hormone variations appear to vary according to sexual orientation among women, but also as a function of cortisol systemic output, allostatic load, and perceived stress for both sexes.

Effects of two dominance manipulations on the stress response: Cognitive and embodied influences

In response to stress, physiological and mental resources are allocated towards those systems that are needed for rapid responding in terms of fight or flight. On the other hand, long term regenerative processes such as growth, digestion and reproduction are attenuated. Levels of the sex steroid testosterone are reduced in participants that suffer from chronic stress. However, beyond its role for reproductive functions, testosterone plays an important role in the regulation of social status and dominance, testosterone levels increase during competition or when the social status is challenged. The Trier Social Stress Test (TSST), a laboratory stressor with a substantial social-evaluative component, can provoke an increase in salivary testosterone levels. Still, so far the reported findings regarding acute stress effects on testosterone are equivocal, possibly due to moderating effects. In this study we experimentally manipulated social dominance in 56 healthy participants (28m) by two independent manipulations (body posture and cognitive role taking) and subjected them to the TSST. We analyzed salivary testosterone and cortisol levels as dependent measures for the endocrine stress response. The role taking manipulation interacted with the testosterone response: we found the strongest increase when participants had to put themselves in a dominant (vs. submissive) role. Our results suggest that transient changes in testosterone levels during stress reflect a response to status threat that is affected by social dominance.

Individual Differences in the Psychobiological Response to Psychosocial Stress (Trier Social Stress Test): The Relevance of Trait Anxiety and Coping Styles

The main objective of this study was to investigate the contribution of some personality traits to the physiological and psychological response to a standardized laboratory psychosocial stressor (trier social stress test). Cortisol and affective response (anxiety and mood) were analysed in a mixed-sex group composed of 35 young adults who participated in a crossover design (18 men and 17 women). After verifying a statistically significant response to the trier social stress test in all parameters studied in both sex groups, exploratory cluster analyses were carried out to identify sub-groups based on their psychophysiological responses. These analyses showed two different groups: subjects displaying lower psychological response along with higher cortisol response (cluster 1) compared with the group with high affective reactivity along with lower cortisol response (cluster 2). Interestingly, we also found significant differences in trait anxiety and coping styles when the two clusters were compared. Subjects in cluster 1 showed lower scores on trait anxiety and higher scores on active coping, whereas the subjects in the second cluster obtained higher scores on anxiety and on coping focused on emotions and mental disengagement. These findings support the importance of personality traits and coping styles in understanding the overall integrative psychobiological responsiveness to social stress.

Hypothalamic-pituitary-adrenal axis response to acute psychosocial stress: Effects of biological sex and circulating sex hormones

Dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis influences the risk for developing stress-related disorders. Sex-dependent differences in the HPA axis stress response are believed to contribute to the different prevalence rates of stress-related disorders found in men and women. However, studies examining the HPA axis stress response have shown mixed support for sex differences, and the role of endogenous sex hormones on HPA axis response has not been adequately examined in humans. This study utilized the largest sample size to date to analyze the effects of biological sex and sex hormones on HPA axis social stress responses. Healthy, 18- to 30- year-old community volunteers (N=282) completed the Trier Social Stress Test (TSST), a widely used and well-validated stress-induction laboratory procedure. All women (n=135) were tested during the follicular phase of their menstrual cycle (when progesterone levels are most similar to men). Adrenocorticotropic hormone (ACTH) and cortisol measures were collected at multiple points throughout pre- and post-TSST. Testosterone and progesterone (in men) and progesterone and estradiol (in women) were determined pre-TSST. Following the TSST, men had greater ACTH and cortisol levels than women. Men had steeper baseline-to-peak and peak-to-end ACTH and cortisol response slopes than women; there was a trend for more cortisol responders among men than women. Testosterone negatively correlated with salivary cortisol response in men, while progesterone negatively correlated with ACTH and cortisol responses in women. These data confirm that men show more robust activation of the HPA axis response to the TSST than do women in the follicular phase of the menstrual cycle. Testosterone results suggest an inhibitory effect on HPA axis reactivity in men. Progesterone results suggest an inhibitory effect on HPA axis reactivity in women. Future work is needed to explain why men mount a greater ACTH and cortisol response to the TSST than do women during the follicular phase of the menstrual cycle.

Neuroendocrinology of a Male-Specific Pattern for Depression Linked to Alcohol Use Disorder and Suicidal Behavior

Epidemiological studies show low rates of diagnosed depression in men compared to women. At the same time, high rates of alcohol use disorders (AUDs) and completed suicide are found among men. These data suggest that a male-specific pattern for depression may exist that is linked to AUDs and suicidal behavior. To date, no underlying neuroendocrine model for this specific pattern of male depression has been suggested. In this paper, we integrate findings related to this specific pattern of depression with underlying steroid secretion patterns, polymorphisms, and methylation profiles of key genes in order to detail an original neuroendocrine model of male-specific depression. Low circulating levels of sex steroids seem to increase the vulnerability for male depression, while concomitant high levels of glucocorticoids further intensify this vulnerability. Interactions of hypothalamus-pituitary-gonadal (HPG) and hypothalamus-pituitary-adrenocortical (HPA) axis-related hormones seem to be highly relevant for a male-specific pattern of depression linked to AUDs and suicidal behavior. Moreover, genetic variants and the epigenetic profiles of the androgen receptor gene, well-known depression related genes, and HPA axis-related genes were shown to further interact with men's steroid secretion and thus may further contribute to the proposed male-specific pattern for depression. This mini-review points out the multilevel interactions between the HPG and HPA axis for a male-specific pattern of depression linked to AUDs and suicidal behavior. An integration of multilevel interactions within the three-hit concept of vulnerability and resilience concludes the review.

Mehr Stress durch G8?

Zusammenfassung. Ziel der vorliegenden Studie war es die Auswirkungen der Schulzeitverkürzung von der neunjährigen (G9) zur achtjährigen (G8) Gymnasialzeit auf die Stressbelastung von Schülern zu untersuchen. An der Studie nahmen insgesamt 69 Abiturienten des doppelten Abiturjahrganges 2013 in NRW teil. Von diesen wurde mit Hilfe der Cortisolkonzentration im Speichel und der subjektiven Stresseinschätzung die Stressbelastung im Schulalltag erfasst. Des Weiteren wurde auch die langfristige Stressbelastung vor und während der Abiturprüfungen betrachtet, indem die Cortisolkonzentration im Haar analysiert wurde. Hierbei zeigte sich, dass die Cortisolkonzentration der beiden untersuchten Schülergruppen im Tagesverlauf sehr ähnlich ist, wobei die G8-Schülerinnen in der Tendenz eine leicht höhere Cortisolkonzentration aufweisen. Auf das subjektive Stressempfinden hat die Schulbiographie jedoch keinen Einfluss. Des Weiteren steigt die Cortisolkonzentration im Haar beider Schülergruppen zwischen der Vorprüfungs- und Prüfungsphase signifikant an, was darauf hindeutet, dass die Prüfungsphase einen langfristigen Stressor darstellt.

Depression history as a moderator of relations between cortisol and shame responses to social-evaluative threat in young adults

Changes in cortisol and shame are commonly elicited by psychosocial stressors involving social-evaluative threat. According to social self preservation theory, this coordinated psychobiological response is adaptive. Individuals with a history of depression, however, may exhibit diminished cortisol reactivity to acute stressors, which could interfere with coordinated cortisol and shame responses. The present study examined temporal relations between cortisol and shame responses to a psychosocial stress task in young adults who varied in their history of depression (56 remitted-depressed, 46 never-depressed). Lagged effects multilevel models revealed that depression history moderated relations between cortisol levels and shame ratings 25-55min later. The pattern of these interactions was similar: whereas higher cortisol levels predicted increases in shame in never-depressed individuals, cortisol levels were unrelated to shame responses in remitted-depressed individuals. Findings suggest a dissociation between cortisol and shame responses to stress in individuals with a history of depression.

Stress, sex, and addiction: potential roles of corticotropin-releasing factor, oxytocin, and arginine-vasopressin

Stress sensitivity and sex are predictive factors for the development of neuropsychiatric disorders. Life stresses are not only risk factors for the development of addiction but also are triggers for relapse to drug use. Therefore, it is imperative to elucidate the molecular mechanisms underlying the interactions between stress and drug abuse, as an understanding of this may help in the development of novel and more effective therapeutic approaches to block the clinical manifestations of drug addiction. The development and clinical course of addiction-related disorders do appear to involve neuroadaptations within neurocircuitries that modulate stress responses and are influenced by several neuropeptides. These include corticotropin-releasing factor, the prototypic member of this class, as well as oxytocin and arginine-vasopressin that play important roles in affiliative behaviors. Interestingly, these peptides function to balance emotional behavior, with sexual dimorphism in the oxytocin/arginine-vasopressin systems, a fact that might play an important role in the differential responses of women and men to stressful stimuli and the specific sex-based prevalence of certain addictive disorders. Thus, this review aims to summarize (i) the contribution of sex differences to the function of dopamine systems, and (ii) the behavioral, neurochemical, and anatomical changes in brain stress systems.

Trained and untrained males show reliable salivary testosterone responses to a physical stimulus, but not a psychological stimulus

BACKGROUND

The testosterone (T) responses to a physical stimulus are thought to be more stable and reproducible compared to a psychological stimulus.

PURPOSE

This study compared the salivary T (Sal-T) responses to both stimuli in four groups of men: professional rugby players (n = 17), recreational rugby players (n = 10), a mixed athlete group (n = 14) and untrained controls (n = 12).

METHODS

Each group completed three treatments: (1) watching a video with aggressive rugby footage, (2) performing a short bout of sprint exercise and (3) a control session. Saliva samples were taken before and 15 min after each treatment.

RESULTS

The sprint exercise changes in Sal-T levels were similar in the elite rugby (17.1 ± 11.1%), recreational rugby (11.9 ± 15.9%), mixed athlete (27.6 ± 32.0%) and control groups (25.3 ± 23.6%). In response to the video, Sal-T increased in the elite rugby (6.9 ± 6.4%) and untrained groups (11.9 ± 13.5%), but decreased in the recreational rugby players (-7.5 ± 11.0%). The individual Sal-T responses to the sprints were also correlated (r = 0.69 to 0.82) with other treatment responses.

CONCLUSIONS

Sprint exercise had a more consistent effect on Sal-T than a video with aggressive content and thus, could provide a reliable stimulus for increasing T availability in men with different training backgrounds. Individual Sal-T reactivity also appears to be somewhat stable across different treatments. These data provide further understanding around the induction, moderation and interpretation of T physiology.

Growing up or growing old? Cellular aging linked with testosterone reactivity to stress in youth

BACKGROUND

Given the established relation between testosterone and aging in older adults, we tested whether buccal telomere length (TL), an established cellular biomarker of aging, was associated with testosterone levels in youth.

METHODS

Children, mean age 10.2 years, were recruited from the greater New Orleans area, and salivary testosterone was measured diurnally and during an acute stressor. Buccal TL was measured using monochrome multiplex quantitative real-time polymerase chain reaction. Testosterone and TL data were available on 77 individuals. The association between buccal TL and testosterone was tested using multivariate generalized estimating equations to account for clustering of children within families.

RESULTS

Greater peak testosterone levels (β = -0.87, P < 0.01) and slower recovery (β = -0.56, P < 0.01) and reactivity (β = -1.22, P < 0.01) following a social stressor were significantly associated with shorter buccal TL after controlling for parental age at conception, child age, sex, sociodemographic factors and puberty. No association was initially present between diurnal measurements of testosterone or morning basal testosterone levels and buccal TL. Sex significantly moderated the relation between testosterone reactivity and buccal TL.

CONCLUSIONS

The association between testosterone and buccal TL supports gonadal maturation as a developmentally sensitive biomarker of aging within youth. As stress levels of testosterone were significantly associated with buccal TL, these findings are consistent with the growing literature linking stress exposure and accelerated maturation. The lack of association of diurnal testosterone or morning basal levels with buccal TL bolsters the notion of a shared stress-related maturational mechanism between cellular stress and the hypothalamic pituitary gonadal axis. These data provide novel evidence supporting the interaction of aging, physiologic stress and cellular processes as an underlying mechanism linking negative health outcomes and early life stress.

Testosterone and social evaluative stress: the moderating role of basal cortisol

Research has suggested that stressful situations lead to a decrease in testosterone, whereas concern with one's social status increases testosterone. However, results from studies examining testosterone reactivity in stressful situations that involve evaluation by others (hence status concerns) are inconsistent. Furthermore, there is a lack of research examining individual differences in testosterone responses in such situations. In this study 85 male participants underwent the Trier Social Stress Test (TSST, which includes performing speech and arithmetic tasks in front of two critical evaluators) and practiced solving puzzles. Testosterone and cortisol levels were assessed from saliva. Across participants, testosterone increased from baseline to peak levels following the stressor tasks. Importantly, the increase in testosterone was larger for participants with lower basal cortisol. Hence, lower basal cortisol (which is known to be associated with low social fearfulness) may help one to mobilize a larger testosterone response in situations that involve social-evaluative stress. Given the hypothesized adaptive role of a larger testosterone response in social competition situations, the results suggest that there may be long-term benefits in learning to lower one's social fearfulness in situations involving potential for negative evaluation by others.

Modeling neuroendocrine stress reactivity in salivary cortisol: adjusting for peak latency variability

In this report, we present growth curve modeling (GCM) with landmark registration as an alternative statistical approach for the analysis of time series cortisol data. This approach addresses an often-ignored but critical source of variability in salivary cortisol analyses: individual and group differences in the time latency of post-stress peak concentrations. It allows for the simultaneous examination of cortisol changes before and after the peak while controlling for timing differences, and thus provides additional information that can help elucidate group differences in the underlying biological processes (e.g., intensity of response, regulatory capacity). We tested whether GCM with landmark registration is more sensitive than traditional statistical approaches (e.g., repeated measures ANOVA--rANOVA) in identifying sex differences in salivary cortisol responses to a psychosocial stressor (Trier Social Stress Test--TSST) in healthy adults (mean age 23). We used plasma ACTH measures as our "standard" and show that the new approach confirms in salivary cortisol the ACTH finding that males had longer peak latencies, higher post-stress peaks but a more intense post-peak decline. This finding would have been missed if only saliva cortisol was available and only more traditional analytic methods were used. This new approach may provide neuroendocrine researchers with a highly sensitive complementary tool to examine the dynamics of the cortisol response in a way that reduces risk of false negative findings when blood samples are not feasible.

Mood and autonomic responses to repeated exposure to the Trier Social Stress Test for Groups (TSST-G)

INTRODUCTION

A group version of the Trier Social Stress Test (TSST-G) was introduced as a standardized, economic and efficient tool to induce a psychobiological stress response simultaneously in a group of subjects. The aim of the present study was to examine the efficacy of the TSST-G to repeatedly induce an affective and autonomic stress response while comparing two alternative protocols for the second examination.

METHODS AND MATERIALS

Healthy young male recruits participated twice in the TSST-G 10 weeks apart. In the first examination, the TSST-G consisted of a combination of mental arithmetic and a fake job interview (TSST-G-1st; n=294). For the second examination, mental arithmetic was combined with either (a) a defensive speech in response to a false shoplifting accusation (TSST-G-2nd-defence; n=105), or (b) a speech on a more neutral topic selected by the investigators (TSST-G-2nd-presentation; n=100). Affect ratings and salivary alpha-amylase (sAA) were determined immediately before and after the stress test, while heart rate (HR) and heart rate variability (HRV) were measured continuously.

RESULTS

TSST-G-1st resulted in a significant increase of negative affect, HR, and sAA, and a significant decrease in positive affect and HRV. TSST-G-2nd, overall, resulted in a significant increase of HR and sAA (the latter only in response to TSST-G-2nd-defence) and a decrease in HRV, while no significant affect alterations were found. When comparing both, TSST-G-2nd-defence and -2nd-presentation, the former resulted in a stronger stress response with regard to HR and HRV.

DISCUSSION

The findings reveal that the TSST-G is a useful protocol to repeatedly evoke an affective and autonomic stress response, while repetition leads to affective but not necessarily autonomic habituation. When interested in examining repeated psychosocial stress reactivity, a task that requires an ego-involving effort, such as a defensive speech, seems to be significantly superior to a task using an impersonal speech.

Developmental and contextual considerations for adrenal and gonadal hormone functioning during adolescence: Implications for adolescent mental health

Substantial research has implicated the hypothalamic-pituitary-adrenal (HPA) and hypothalamic-pituitary-gonadal (HPG) axes independently in adolescent mental health problems, though this literature remains largely inconclusive. Given the cross-talk between the HPA and HPG axes and their increased activation in adolescence, a dual-axis approach that examines both axes simultaneously is proposed to predict the emergence and persistence of adolescent mental health problems. After briefly orienting readers to HPA and HPG axis functioning, we review the literature examining associations between hormone levels and changes with behavior during adolescence. Then, we provide a review of the literature supporting examination of both axes simultaneously and present the limited research that has taken a dual-axis approach. We propose future directions including consideration of between-person and within-person approaches to address questions of correlated changes in HPA and HPG hormones. Potential moderators are considered to increase understanding of the nuanced hormone-behavior associations during key developmental transitions.

Assessment of stress associated with an oral public speech in veterinary students by salivary biomarkers

In this report, salivary cortisol, alpha-amylase activity, and testosterone were measured to assess stress associated with a public oral presentation in Veterinary Clinical Pathology students. Stimulated saliva samples were collected before and directly after a 5-minute oral presentation and at 20 and 35 minutes after the beginning of the presentation. Cortisol peaked 20 minutes after the beginning of the presentation, whereas salivary alpha-amylase (sAA) peaked at 5 minutes, just at the end of the speech. These changes were not related to the level of stress that was indicated by the student in a questionnaire, the student's sex, or the quality of the presentation. No changes were detected in testosterone levels during the study. Saliva biomarkers evaluated in this research could be extended to other stress-producing situations in the university life of veterinary students.

Biological and psychological markers of stress in humans: focus on the Trier Social Stress Test

Validated biological and psychological markers of acute stress in humans are an important tool in translational research. The Trier Social Stress Test (TSST), involving public interview and mental arithmetic performance, is among the most popular methods of inducing acute stress in experimental settings, and reliably increases hypothalamic-pituitary-adrenal axis activation. However, although much research has focused on HPA axis activity, the TSST also affects the sympathetic-adrenal-medullary system, the immune system, cardiovascular outputs, gastric function and cognition. We critically assess the utility of different biological and psychological markers, with guidance for future research, and discuss factors which can moderate TSST effects. We outline the effects of the TSST in stress-related disorders, and if these responses can be abrogated by pharmacological and psychological treatments. Modified TSST protocols are discussed, and the TSST is compared to alternative methods of inducing acute stress. Our analysis suggests that multiple readouts are necessary to derive maximum information; this strategy will enhance our understanding of the psychobiology of stress and provide the means to assess novel therapeutic agents.

High testosterone levels and sensitivity to acute stress in perpetrators of domestic violence with low cognitive flexibility and impairments in their emotional decoding process: a preliminary study

Hormonal and neuropsychological impairment in intimate partner violence (IPV) perpetrators could play a role in domestic violence. For characterizing whether there is a specific psychobiological response to stress, participants who had previously been jailed for IPV and controls were compared for testosterone and cortisol levels, tested for 2D:4D ratio (as an indicator of masculinization), and given several trait questionnaires and neuropsychological tests related to executive functions and theory of mind. After performing the Trier Social Stress Test (TSST), IPV perpetrators experienced decreases in salivary testosterone (T) levels, a moderate worsening of mood, slight anxiety, and a salivary cortisol (C) level increase. Moreover, high basal T was related with high levels of anger and anxiety and worse mood. However, that basal mood does not significantly alter T levels in response to stress. Nonetheless, controls experienced smaller changes in T and larger changes in C and psychological mood. With respect to neuropsychological and cognitive empathic features, IPV perpetrators showed poorer executive performance and emotional recognition than controls. In addition, deficits in both neuropsychological domains were positively associated. Regarding emotional empathy, IPV perpetrators showed higher levels of personal distress than controls. The 2D:4D ratio was lower in IPV perpetrators than in controls. Moreover, only in the former a smaller 2D:4D ratio was related to large increases in T in response to stress and poor emotional recognition. Together with social aspects involved in IPV, differences in psychobiological variables and their relationships could play a relevant role in the onset and perpetuation of violent behavior.

Acute pre-learning stress and declarative memory: impact of sex, cortisol response and menstrual cycle phase

This study explores the influence of pre-learning stress on performance on declarative memory tasks in healthy young adults in relation to sex and menstrual cycle phase. The sample was composed of 119 students (32 men and 87 women) from 18 to 25 years of age. The women were tested in different hormonal stages (30 in follicular phase, 34 in luteal phase, and 23 using oral contraceptives). The participants were exposed to the Trier Social Stress Test (TSST) or a control condition. Afterwards, their memory performance was measured using a standardized memory test (Rey's Auditory Verbal Learning Test). In the control condition, all groups of women recalled more words than men, but these differences disappeared in the group exposed to TSST because men's performance on the memory test improved, but only to the level of women. In addition, our data suggest that in women the relationship between cortisol and memory can be modulated by sex hormone levels, since in luteal women a negative relationship was found between memory performance and peak cortisol level. These results confirm that sex differences need to be considered in the relationship between pre-learning stress and memory performance.

Association of maternal exposure to childhood abuse with elevated risk for autism in offspring

IMPORTANCE

Adverse perinatal circumstances have been associated with increased risk for autism in offspring. Women exposed to childhood abuse experience more adverse perinatal circumstances than women unexposed, but whether maternal abuse is associated with autism in offspring is unknown.

OBJECTIVES

To determine whether maternal exposure to childhood abuse is associated with risk for autism in offspring and whether possible increased risk is accounted for by a higher prevalence of adverse perinatal circumstances among abused women, including toxemia, low birth weight, gestational diabetes, previous induced abortion, intimate partner abuse, pregnancy length shorter than 37 weeks, selective serotonin reuptake inhibitor use, and alcohol use and smoking during pregnancy.

DESIGN AND SETTING

Nurses' Health Study II, a population-based longitudinal cohort of 116 430 women.

PARTICIPANTS

Nurses with data on maternal childhood abuse and child's autism status (97.0% were of white race/ethnicity). Controls were randomly selected from among children of women who did not report autism in offspring (participants included 451 mothers of children with autism and 52 498 mothers of children without autism).

MAIN OUTCOME MEASURES

Autism spectrum disorder in offspring, assessed by maternal report and validated with the Autism Diagnostic Interview-Revised in a subsample.

RESULTS

Exposure to abuse was associated with increased risk for autism in children in a monotonically increasing fashion. The highest level of abuse was associated with the greatest prevalence of autism (1.8% vs 0.7% among women not abused, P = .005) and with the greatest risk for autism adjusted for demographic factors (risk ratio, 3.7; 95% CI, 2.3-5.8). All adverse perinatal circumstances except low birth weight were more prevalent among women abused in childhood. Adjusted for perinatal factors, the association of maternal childhood abuse with autism in offspring was slightly attenuated (risk ratio for highest level of abuse, 3.0; 95% CI, 1.9-4.8).

CONCLUSIONS AND RELEVANCE

We identify an intergenerational association between maternal exposure to childhood abuse and risk for autism in the subsequent generation. Adverse perinatal circumstances accounted for only a small portion of this increased risk.

Sex differences in anxiety and emotional behavior

Research has elucidated causal links between stress exposure and the development of anxiety disorders, but due to the limited use of female or sex-comparative animal models, little is known about the mechanisms underlying sex differences in those disorders. This is despite an overwhelming wealth of evidence from the clinical literature that the prevalence of anxiety disorders is about twice as high in women compared to men, in addition to gender differences in severity and treatment efficacy. We here review human gender differences in generalized anxiety disorder, panic disorder, posttraumatic stress disorder and anxiety-relevant biological functions, discuss the limitations of classic conflict anxiety tests to measure naturally occurring sex differences in anxiety-like behaviors, describe sex-dependent manifestation of anxiety states after gestational, neonatal, or adolescent stressors, and present animal models of chronic anxiety states induced by acute or chronic stressors during adulthood. Potential mechanisms underlying sex differences in stress-related anxiety states include emerging evidence supporting the existence of two anatomically and functionally distinct serotonergic circuits that are related to the modulation of conflict anxiety and panic-like anxiety, respectively. We discuss how these serotonergic circuits may be controlled by reproductive steroid hormone-dependent modulation of crfr1 and crfr2 expression in the midbrain dorsal raphe nucleus and by estrous stage-dependent alterations of γ-aminobutyric acid (GABAergic) neurotransmission in the periaqueductal gray, ultimately leading to sex differences in emotional behavior.