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James KA, Stromin JI, Steenkamp N, Combrinck MI. Understanding the relationships between physiological and psychosocial stress, cortisol and cognition. Front Endocrinol (Lausanne) 2023; 14:1085950. [PMID: 36950689 PMCID: PMC10025564 DOI: 10.3389/fendo.2023.1085950] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 02/14/2023] [Indexed: 03/08/2023] Open
Abstract
Stress is viewed as a state of real or perceived threat to homeostasis, the management of which involves the endocrine, nervous, and immune systems. These systems work independently and interactively as part of the stress response. The scientific stress literature, which spans both animal and human studies, contains heterogeneous findings about the effects of stress on the brain and the body. This review seeks to summarise and integrate literature on the relationships between these systems, examining particularly the roles of physiological and psychosocial stress, the stress hormone cortisol, as controlled by the hypothalamic-pituitary-adrenal (HPA) axis, and the effects of stress on cognitive functioning. Health conditions related to impaired HPA axis functioning and their associated neuropsychiatric symptoms will also be considered. Lastly, this review will provide suggestions of clinical applicability for endocrinologists who are uniquely placed to measure outcomes related to endocrine, nervous and immune system functioning and identify areas of intervention.
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Affiliation(s)
- Katharine Ann James
- Applied Cognitive Science and Experimental Neuropsychology Team (ACSENT) Laboratory, Department of Psychology, University of Cape Town, Cape Town, South Africa
- Division of Geriatric Medicine, Department of Medicine, University of Cape Town, Cape Town, South Africa
| | - Juliet Ilena Stromin
- Applied Cognitive Science and Experimental Neuropsychology Team (ACSENT) Laboratory, Department of Psychology, University of Cape Town, Cape Town, South Africa
| | - Nina Steenkamp
- Applied Cognitive Science and Experimental Neuropsychology Team (ACSENT) Laboratory, Department of Psychology, University of Cape Town, Cape Town, South Africa
| | - Marc Irwin Combrinck
- Division of Geriatric Medicine, Department of Medicine, University of Cape Town, Cape Town, South Africa
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Yang J, Kershaw KN. Feasibility of using ecological momentary assessment and continuous heart rate monitoring to measure stress reactivity in natural settings. PLoS One 2022; 17:e0264200. [PMID: 35263368 PMCID: PMC8906632 DOI: 10.1371/journal.pone.0264200] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Accepted: 02/06/2022] [Indexed: 01/28/2023] Open
Abstract
The way people respond to stressful situations (i.e., stress reactivity) varies widely. Researchers typically measure stress reactivity in controlled studies, but this is limited because laboratory stressors cannot capture the variety, severity, or duration of stressors that individuals face in their daily lives. The present study examined the feasibility of using ecological momentary assessment (EMA) and a wireless electrocardiography (ECG) patch to develop an understanding of stress reactivity in natural settings. Thirty-five adult women completed EMA surveys about stressors they were exposed to while wearing a wireless ECG monitor for 7 consecutive days. Daily stressors were measured using seven questions adapted from the Daily Inventory of Stressful Events and a stressor interval was defined as the presence of at least one stressor during the EMA survey prompt. Participants wore the Cardea SOLO wireless ECG monitor (Cardiac Insight Inc., Bellevue, WA) to continuously track their heart rate. Participant-specific differences in 5-minute heart rate variability (HRV) between intervals when participants did and did not report stressors were calculated and displayed in a heat map. Survey response rate was satisfactory (72.0%, n = 588) and nearly all participants (33 out of 35) reported both stressor and non-stressor intervals. Each participant reported at least one stressor on approximately 35% of completed surveys while wearing the ECG patch. Mean wear time (6.6 days) and the duration of analyzable data with an ECG monitor were close to the 7-day study period. While many participants had lower HRV during stressor versus non-stressor intervals, the magnitude and direction of these differences varied widely. In summary, we found that a 7-day sampling scheme combining ecological momentary assessment (EMA) with HRV measured using continuous ECG monitoring was feasible and effective in capturing a variety of daily stressors and measuring autonomic stress reactivity.
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Affiliation(s)
- Jessica Yang
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, United States of America
| | - Kiarri N. Kershaw
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, United States of America
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Ayala-Grosso C, Torrico F, Ledezma-Ruiz M, Busolo-Pons M. Chronic Stress in Cognitive Processes: Cortisol Dynamic Range of Secretion Is Associated with Perception of Unsafety Environment in a Venezuelan Population. J Alzheimers Dis 2020; 82:S299-S312. [PMID: 33285631 DOI: 10.3233/jad-200886] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Understanding diurnal secretion of cortisol in association with behavioral attitudes as a result of perception of unsafety environment is a main interest in prospective studies establishing the impact of chronic stress in cognitive processes. Adaptive secretion of cortisol, a biomarker of the hypothalamic-hypophysis-adrenal (HPA) axis, has been correlated with perception of uncertainty in surroundings as a consequence of perseverative cognition and unconscious thoughts. OBJECTIVE To determine whether diurnal secretion pattern of cortisol was associated with behavioral attitudes indexes generated from answers to standardized questionnaires from Panamerican Health Organization/World Health Organization (PAHO/WHO) agencies. METHODS Saliva cortisol dynamic range was evaluated by immuno-essay. Cortisol awakening response (CAR) and total secreted cortisol was established in a cross-sectional study of four saliva samples per day from volunteers (n = 135) between 19 and 65 years old. RESULTS Saliva cortisol dynamic range followed a significant decay along the day. Reduction of social interaction and increase of defensive behavioral attitude was associated with older groups of age. In this study, two subgroups of subjects with a steeper cortisol secretion (slope significant non-zero), and flatter cortisol secretion (slope no significant non-zero) were detected. Noticeable, we determined an association between measurements of cortisol secretion from subjects with a flatter cortisol dynamic range and behavioral defensive and inhibition of social interaction indexes. CONCLUSION These findings suggested chronical dysregulation of HPA axis as a result of perseverative cognitive perception of unsafety environment which may be precedent to cognitive impairment in the population.
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Affiliation(s)
- Carlos Ayala-Grosso
- Unit of Cellular Therapy, Centre of Experimental Medicine, Instituto Venezolano de Investigaciones Científicas IVIC, Caracas, Venezuela
| | - Fátima Torrico
- Unit of Molecular Biology, School of Pharmacy, Universidad Central de Venezuela, Caracas, Venezuela
| | - Margot Ledezma-Ruiz
- Unit of Molecular Biology, School of Pharmacy, Universidad Central de Venezuela, Caracas, Venezuela
| | - Maria Busolo-Pons
- Unit of Molecular Biology, School of Pharmacy, Universidad Central de Venezuela, Caracas, Venezuela
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Stress effects on cognitive function in patients with major depressive disorder: Does childhood trauma play a role? Dev Psychopathol 2020; 32:1007-1016. [PMID: 31366417 DOI: 10.1017/s0954579419000932] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Impaired cognitive functioning constitutes an important symptom of major depressive disorder (MDD), potentially associated with elevated cortisol levels. Adverse childhood experiences (ACE) enhance the risk for MDD and can contribute to disturbances in the stress systems, including cortisol and cognitive functions. In healthy participants, cortisol administration as well as acute stress can affect cognitive performance. In the current study, we tested cognitive performance in MDD patients with (N = 32) and without (N = 52) ACE and healthy participants with (N = 22) and without (N = 37) ACE after psychosocial stress induction (Trier Social Stress Test, TSST) and a control condition (Placebo-TSST). MDD predicted lower performance in verbal learning and both selective and sustained attention, while ACE predicted lower performance in psychomotoric speed and working memory. There were no interaction effects of MDD and ACE. After stress, MDD patients were more likely to show lower performance in working memory as well as in selective and sustained attention compared with participants without MDD. Individuals with ACE were more likely to show lower performance in verbal memory after stress compared with individuals without ACE. Our results indicate negative effects of MDD and ACE on distinct cognitive domains. Furthermore, MDD and/or ACE seem to enhance susceptibility for stress-related cognitive impairments.
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Dumont L, Marin MF, Lupien SJ, Juster RP. Sex Differences in Work-Stress Memory Bias and Stress Hormones. Brain Sci 2020; 10:brainsci10070432. [PMID: 32650392 PMCID: PMC7408118 DOI: 10.3390/brainsci10070432] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Revised: 06/26/2020] [Accepted: 07/01/2020] [Indexed: 11/16/2022] Open
Abstract
Mental health problems related to chronic stress in workers appear to be sex-specific. Psychosocial factors related to work-life balance partly explain these sex differences. In addition, physiological markers of stress can provide critical information on the mechanisms explaining how chronic stress gets "under the skull" to increase vulnerability to mental health disorders in working men and women. Stress hormones access the brain and modulate attentional and memory process in favor of threatening information. In the present study, we tested whether male and female workers present a memory bias towards work-stress related information, and whether this bias is associated with concentrations of stress hormones in reactivity to a laboratory stressor (reactive levels) and samples taken in participants' workday (diurnal levels). In total, 201 participants (144 women) aged between 18 and 72 years underwent immediate and delayed recall tasks with a 24-word list, split as a function of valence (work-stress, positive, neutral). Participants were exposed to a psychosocial stressor in between recalls. Reactivity to stress was measured with saliva samples before and after the stressor. Diurnal cortisol was also measured with five saliva samples a day, during 2 workdays. Our exploratory results showed that men presented greater cortisol reactivity to stress than women, while women recalled more positive and neutral words than men. No sex difference was detected on the recall of work-stress words, before or after exposure to stress. These results do not support the hypothesis of a sex-specific cognitive bias as an explanatory factor for sex differences in stress-related mental health disorders in healthy male and female workers. However, it is possible that such a work-stress bias is present in individuals who have developed a mental-health disorder related to workplace stress or who have had one in the recent past. Consequently, future studies could use our stress memory bias task to assess this and other hypotheses in diverse working populations.
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Affiliation(s)
- Laurence Dumont
- Centre de recherche de l’Institut Universitaire en Santé Mentale de Montréal, Montreal, QC H1N 3V2, Canada; (M.-F.M.); (S.J.L.); (R.-P.J.)
- Department of Psychiatry and Addiction, Université de Montréal, Montreal, QC H1N 3V2, Canada
- Center for Studies on Human Stress, Montreal, QC H1N 3V2, Canada
- Correspondence:
| | - Marie-France Marin
- Centre de recherche de l’Institut Universitaire en Santé Mentale de Montréal, Montreal, QC H1N 3V2, Canada; (M.-F.M.); (S.J.L.); (R.-P.J.)
- Department of Psychiatry and Addiction, Université de Montréal, Montreal, QC H1N 3V2, Canada
- Center for Studies on Human Stress, Montreal, QC H1N 3V2, Canada
- Department of Psychology, Université du Québec à Montréal, Montreal, QC H3C 3P8, Canada
| | - Sonia J. Lupien
- Centre de recherche de l’Institut Universitaire en Santé Mentale de Montréal, Montreal, QC H1N 3V2, Canada; (M.-F.M.); (S.J.L.); (R.-P.J.)
- Department of Psychiatry and Addiction, Université de Montréal, Montreal, QC H1N 3V2, Canada
- Center for Studies on Human Stress, Montreal, QC H1N 3V2, Canada
| | - Robert-Paul Juster
- Centre de recherche de l’Institut Universitaire en Santé Mentale de Montréal, Montreal, QC H1N 3V2, Canada; (M.-F.M.); (S.J.L.); (R.-P.J.)
- Department of Psychiatry and Addiction, Université de Montréal, Montreal, QC H1N 3V2, Canada
- Center on Sex*Gender, Allostasis, and Resilience, Montreal, QC H1N 3V2, Canada
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de Souza-Talarico JN, Alves AR, Brucki SMD, Nitrini R, Lupien SJ, Suchecki D. Cortisol reactivity to a psychosocial stressor significantly increases the risk of developing Cognitive Impairment no Dementia five years later. Psychoneuroendocrinology 2020; 115:104601. [PMID: 32087524 DOI: 10.1016/j.psyneuen.2020.104601] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Revised: 01/08/2020] [Accepted: 02/01/2020] [Indexed: 12/24/2022]
Abstract
Alzheimer's disease (AD) patients show high cortisol levels suggesting that biological mediators of stress may play a role in the neurodegenerative process of cognitive disorders. However, there is no consensus as to whether cortisol concentrations represent a risk factor for the development of cognitive impairment. We analyzed the potential association between the incidence of cognitive impairment and cortisol concentrations under basal and acute stress conditions in 129 individuals aged 50 years or older, with preserved cognitive and functional abilities. All participants were recruited in 2011 for assessment of cognitive performance and cortisol levels. Cortisol was analyzed in saliva samples collected during two typical and consecutive days, in the morning, afternoon, and night, and also during exposure to an acute psychosocial stressor (Trier Social Stress Test - TSST). After a five-year follow-up, 69 of these volunteers were reassessed for cognitive performance, functional evaluation, memory complaints, and depression. The incidence of cognitive impairment not dementia (CIND) was 26.1 %, and was positively associated with greater TSST-induced cortisol release (responsiveness) [(95 % CI = 1.001-1.011; B = 0.006), p = 0.023]. Moreover, five years before diagnosis, participants who later developed CIND had greater responsiveness to TSST (p = 0.019) and lower cortisol awakening response (CAR: p = 0.018), as compared to those who did not develop CIND. These findings suggest that higher psychosocial stress responsiveness profiles may represent a preclinical sign of cognitive impairment.
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Affiliation(s)
| | - Andrea Regiani Alves
- Department of Medical-Surgical Nursing, School of Nursing, Universidade de São Paulo, São Paulo, 05403 000, Brazil
| | - Sonia Maria Dozzi Brucki
- Department of Neurology, Faculty of Medicine, Universidade de São Paulo, São Paulo, 05403 000, Brazil
| | - Ricardo Nitrini
- Department of Neurology, Faculty of Medicine, Universidade de São Paulo, São Paulo, 05403 000, Brazil
| | - Sonia J Lupien
- Centre for Studies on Human Stress, Mental Health Research Centre Fernand Seguin, Hospital Louis H. Lafontaine, Université de Montréal, Montréal, QC, H1N 3V2, Canada
| | - Deborah Suchecki
- Department of Psychobiology, Universidade Federal de São Paulo, São Paulo, 04023-062, Brazil
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James KA, Grace LK, Pan CY, Combrinck MI, Thomas KGF. Psychosocial stress associated with memory performance in older South African adults. AGING NEUROPSYCHOLOGY AND COGNITION 2019; 27:553-566. [PMID: 31419919 DOI: 10.1080/13825585.2019.1645809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Older adults with past or current chronic stress exposure perform poorly on memory assessments and are at higher risk for Alzheimer's disease (AD). In low- or middle-income countries, many older adults are, or have been, exposed to stress-provoking events. Few published studies examine such populations, however, and few take multiple measures of stress. In a sample of South African older adults with mild-to-moderate AD (n = 65) and healthy controls (n = 69), we assessed relations between stress (psychosocial and physiological), memory performance, and patient status. Participants, all aged > 60, were administered the Perceived Stress Scale (a questionnaire assessing subjective psychosocial stress) and the Cambridge Cognitive Examination-Revised (CAMCOG-R; a test battery measuring performance across several cognitive domains). We measured their salivary cortisol concentrations as a proxy for physiological stress. Patients reported significantly higher levels of psychosocial stress than controls, p = .008. Logistic regression showed that psychosocial stress, but not cortisol, predicted AD patient status. CAMCOG-R Memory subscale scores were significantly associated with psychosocial stress, r = -.18, p = .040, but not with cortisol levels. These findings are the first on the topic to emerge from a low-or middle-income country. We replicated findings from previous studies conducted in high-income countries, with data supporting predictions derived from the glucocorticoid cascade/neurotoxicity hypothesis. The results suggest that clinical interventions focused on increasing resilience of older adults to effects of chronic stress may help protect against declining memory performance and reduce the risk for AD.
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Affiliation(s)
- Katharine A James
- ACSENT Laboratory, Department of Psychology, University of Cape Town, Rondebosch, South Africa.,Division of Geriatric Medicine, Department of Medicine, University of Cape Town, Rondebosch, South Africa
| | - Laurian K Grace
- Division of Geriatric Medicine, Department of Medicine, University of Cape Town, Rondebosch, South Africa
| | - Chen Ying Pan
- ACSENT Laboratory, Department of Psychology, University of Cape Town, Rondebosch, South Africa
| | - Marc I Combrinck
- Division of Geriatric Medicine, Department of Medicine, University of Cape Town, Rondebosch, South Africa
| | - Kevin G F Thomas
- ACSENT Laboratory, Department of Psychology, University of Cape Town, Rondebosch, South Africa
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