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Stromájer GP, Csima M, Iváncsik R, Varga B, Takács K, Stromájer-Rácz T. Stress and Anxiety among High School Adolescents: Correlations between Physiological and Psychological Indicators in a Longitudinal Follow-Up Study. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1548. [PMID: 37761509 PMCID: PMC10529881 DOI: 10.3390/children10091548] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 09/11/2023] [Accepted: 09/12/2023] [Indexed: 09/29/2023]
Abstract
Mental and psychological disorders are serious health problems worldwide. Anxiety among high school students can affect school performance, relationships, and family life. OBJECTIVE Our aim is to understand the anxiety levels and associated factors among high school students and compare the results of psychological tests measuring anxiety with the cortisol levels obtained from biological sampling. METHOD In our longitudinal follow-up study, we involved 125 individuals in May 2019. Validated measurement tools were used during questionnaire data collection, including the State-Trait Anxiety Inventory, Clear Communication Scale, Multiple Social Perceived Support Scale, and related HBSC questions. As objective data, we collected hair samples for cortisol level measurement. RESULTS At the end of the school year, the anxiety levels measured by psychological tests were significantly higher (p = 0.001) compared to the anxiety levels at the beginning of the next school year. Anxiety levels were higher among girls and were influenced by the type of school and parental expectations. Both state anxiety and trait anxiety showed a strong correlation with psychosomatic symptoms (p < 0.001) and anxiety arising from school expectations (p < 0.05). The changes in cortisol levels did not follow the changes in psychological tests. Cortisol level increased (p = 0.01) in the second sample.
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Affiliation(s)
- Gábor Pál Stromájer
- Institute of Basics of Health Sciences, Midwifery and Health Visiting, Faculty of Health Sciences, University of Pécs, H-7621 Pécs, Hungary; (G.P.S.); (B.V.); (K.T.)
| | - Melinda Csima
- Institute of Education, Hungarian University of Agriculture and Life Sciences, H-7400 Kaposvár, Hungary; (M.C.); (R.I.)
| | - Réka Iváncsik
- Institute of Education, Hungarian University of Agriculture and Life Sciences, H-7400 Kaposvár, Hungary; (M.C.); (R.I.)
| | - Bernadett Varga
- Institute of Basics of Health Sciences, Midwifery and Health Visiting, Faculty of Health Sciences, University of Pécs, H-7621 Pécs, Hungary; (G.P.S.); (B.V.); (K.T.)
| | - Krisztina Takács
- Institute of Basics of Health Sciences, Midwifery and Health Visiting, Faculty of Health Sciences, University of Pécs, H-7621 Pécs, Hungary; (G.P.S.); (B.V.); (K.T.)
| | - Tímea Stromájer-Rácz
- Institute of Diagnostic, Faculty of Health Sciences, University of Pécs, H-7621 Pécs, Hungary
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Teo CH, Wong ACH, Sivakumaran RN, Parhar I, Soga T. Gender Differences in Cortisol and Cortisol Receptors in Depression: A Narrative Review. Int J Mol Sci 2023; 24:ijms24087129. [PMID: 37108291 PMCID: PMC10138698 DOI: 10.3390/ijms24087129] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2023] [Revised: 03/17/2023] [Accepted: 03/23/2023] [Indexed: 04/29/2023] Open
Abstract
Stress is known to have a significant impact on mental health. While gender differences can be found in stress response and mental disorders, there are limited studies on the neuronal mechanisms of gender differences in mental health. Here, we discuss gender and cortisol in depression as presented by recent clinical studies, as well as gender differences in the role of glucocorticoid receptors (GRs) and mineralocorticoid receptors (MRs) in stress-associated mental disorders. When examining clinical studies drawn from PubMed/MEDLINE (National Library of Medicine) and EMBASE, salivary cortisol generally showed no gender correlation. However, young males were reported to show heightened cortisol reactivity compared to females of similar age in depression. Pubertal hormones, age, early life stressors, and types of bio-samples for cortisol measurement affected the recorded cortisol levels. The role of GRs and MRs in the HPA axis could be different between males and females during depression, with increased HPA activity and upregulated MR expression in male mice, while the inverse happened in female mice. The functional heterogeneity and imbalance of GRs and MRs in the brain may explain gender differences in mental disorders. This knowledge and understanding will support the development of gender-specific diagnostic markers involving GRs and MRs in depression.
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Affiliation(s)
- Chuin Hau Teo
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway, Kuala Lumpur 47500, Selangor, Malaysia
| | - Ally Chai Hui Wong
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway, Kuala Lumpur 47500, Selangor, Malaysia
| | - Rooba Nair Sivakumaran
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway, Kuala Lumpur 47500, Selangor, Malaysia
| | - Ishwar Parhar
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway, Kuala Lumpur 47500, Selangor, Malaysia
| | - Tomoko Soga
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway, Kuala Lumpur 47500, Selangor, Malaysia
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3
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Raymond C, Bilodeau-Houle A, Zerroug Y, Provencher J, Beaudin M, Marin MF. Pre-pandemic socio-emotional vulnerability, internalizing and externalizing symptoms predict changes in hair cortisol concentrations in reaction to the COVID-19 pandemic in children. Psychoneuroendocrinology 2022; 144:105888. [PMID: 35933864 PMCID: PMC9344696 DOI: 10.1016/j.psyneuen.2022.105888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 06/29/2022] [Accepted: 07/29/2022] [Indexed: 11/07/2022]
Abstract
The COVID-19 pandemic led to increased distress in many children, particularly in girls. Socio-emotional vulnerability, as well as psychiatric symptomatology prior to or during the initial stages of the pandemic, have been identified as important predictors of this distress. Still, it is unclear whether the pandemic also had physiological repercussions in children. If so, it remains to be determined whether these same predictors could provide insight into inter-individual variability. This longitudinal study aimed to investigate the effects of socio-emotional vulnerability, as well as pre-pandemic internalizing and externalizing symptoms, on hair cortisol concentrations (HCC) in response to the COVID-19 pandemic in healthy youth. In June 2020 (T1), 69 healthy children (M = 11.57 y/o) who visited the laboratory between 2017 and 2019 (T0) provided a 6 cm hair sample. This technique allowed us to quantify cortisol secretion during the three months preceding the COVID-19 pandemic (Segment A) and during the first three months of the first wave of the pandemic in Quebec, Canada (Segment B). At T0, participants completed the Dominic Interactive to assess pre-pandemic internalizing and externalizing symptoms. A socio-emotional composite score (SECS) was derived using a weighted z-score with the following constructs: anxiety sensitivity (Childhood Anxiety Sensitivity Index) measured at T0, trait anxiety (Trait subscale of the State-Trait Anxiety Inventory for Children (STAI-C)), intolerance of uncertainty (Intolerance of Uncertainty Scale for Children), and trait rumination (Children's Response Style Scale) measured at T1. A linear regression was conducted using the percent change in HCC across Segment A and B as the dependent variable, where SECS, pre-pandemic internalizing and externalizing symptoms, and sex were used as predictors. We found a main effect of sex, with girls presenting increased HCC reactivity compared to boys. We also found that SECS and internalizing symptoms negatively predicted HCC, whereas the opposite relationship was found between externalizing symptoms and HCC reactivity. For healthy children, our results suggest that previous psychiatric symptoms and socio-emotional vulnerability may be risk factors for the presentation of diverging cortisol response patterns in response to an adverse life event (such as the COVID-19 pandemic).
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Affiliation(s)
- Catherine Raymond
- Department of Psychology, Université du Québec à Montréal, Montreal, QC, Canada,Research Centre of the Institut Universitaire en Santé Mentale de Montréal, Montreal, QC, Canada
| | - Alexe Bilodeau-Houle
- Department of Psychology, Université du Québec à Montréal, Montreal, QC, Canada,Research Centre of the Institut Universitaire en Santé Mentale de Montréal, Montreal, QC, Canada
| | - Yasmine Zerroug
- Department of Psychology, Université du Québec à Montréal, Montreal, QC, Canada,Research Centre of the Institut Universitaire en Santé Mentale de Montréal, Montreal, QC, Canada
| | - Jessie Provencher
- Department of Psychology, Université du Québec à Montréal, Montreal, QC, Canada,Research Centre of the Institut Universitaire en Santé Mentale de Montréal, Montreal, QC, Canada
| | - Myriam Beaudin
- Department of Psychology, Université du Québec à Montréal, Montreal, QC, Canada,Research Centre of the Institut Universitaire en Santé Mentale de Montréal, Montreal, QC, Canada
| | - Marie-France Marin
- Department of Psychology, Université du Québec à Montréal, Montreal, QC, Canada; Research Centre of the Institut Universitaire en Santé Mentale de Montréal, Montreal, QC, Canada.
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Shen C, Mireku MO, Di Simplicio M, Dumontheil I, Thomas MSC, Röösli M, Elliott P, Toledano MB. Bidirectional associations between sleep problems and behavioural difficulties and health-related quality of life in adolescents: Evidence from the SCAMP longitudinal cohort study. JCPP ADVANCES 2022; 2:e12098. [PMID: 36941946 PMCID: PMC10021029 DOI: 10.1002/jcv2.12098] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Accepted: 07/18/2022] [Indexed: 11/07/2022] Open
Abstract
Background Sleep problems show associations with negative outcomes in both physical and mental health in adolescents, but the associations may be reciprocal. We aimed to assess bidirectional associations between sleep problems and mental health symptoms including behavioural difficulties (internalising and externalising difficulties) and low health-related quality of life (HRQoL). Methods A total of 6616 adolescents (52.4% females) across Greater London completed baseline assessments when they were aged 11-12 years, and 3803 of them (57.2% females) completed follow-up assessments at aged 13-15 years. Weekday and weekend sleep duration were derived from self-reported bedtime, sleep onset latency and wake time. Sleep disturbance was assessed using a standardized sleep disturbance scale. Internalising and externalising difficulties were assessed using subscales of the Strength and Difficulties Questionnaire. HRQoL was assessed using the KIDSCREEN-10 questionnaire. Cross-lagged structural equation modelling was used with multiple imputation to examine bidirectional associations between sleep problems and mental health symptoms. Results Females had greater internalising difficulties, worse HRQoL and more sleep disturbance than males. Persistent insufficient weekday and weekend sleep, and sleep disturbance (i.e., at both baseline and follow-up) were associated with internalising and externalising difficulties and low HRQoL at follow-up (ORs ranged from 1.53 to 3.63). Persistent externalising difficulties and low HRQoL were also associated with insufficient weekend sleep and sleep disturbance at follow-up (ORs ranged from 1.68 to 4.25). Using continuous variables, we found bidirectional associations between weekday sleep duration and HRQoL, weekend sleep duration and externalising score, sleep quality and internalising score, and sleep quality and HRQoL. The association magnitudes were mostly similar in the two directions. Conclusions Our study showed bidirectional associations between sleep problems and mental health symptoms during adolescence, indicating that early intervention and treatment on the first-occurring symptom may prevent the development of subsequent problems.
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Affiliation(s)
- Chen Shen
- Department of Epidemiology and BiostatisticsMRC Centre for Environment and HealthSchool of Public HealthImperial College LondonLondonUK
- National Institute for Health Research Health Protection Research Unit in Chemical and Radiation Threats and HazardsImperial College LondonLondonUK
| | - Michael O. Mireku
- School of PsychologyUniversity of LincolnLincolnUK
- Lincoln Sleep Research CentreUniversity of LincolnLincolnUK
| | - Martina Di Simplicio
- Department of Brain SciencesDivision of PsychiatryImperial College LondonLondonUK
| | - Iroise Dumontheil
- Department of Psychological SciencesBirkbeck, University of LondonLondonUK
| | | | - Martin Röösli
- Department of Epidemiology and Public HealthSwiss Tropical and Public Health InstituteBaselSwitzerland
- Faculty of ScienceUniversity of BaselBaselSwitzerland
| | - Paul Elliott
- Department of Epidemiology and BiostatisticsMRC Centre for Environment and HealthSchool of Public HealthImperial College LondonLondonUK
- National Institute for Health Research Health Protection Research Unit in Chemical and Radiation Threats and HazardsImperial College LondonLondonUK
- National Institute for Health Research Biomedical Research CentreImperial College LondonLondonUK
| | - Mireille B. Toledano
- Department of Epidemiology and BiostatisticsMRC Centre for Environment and HealthSchool of Public HealthImperial College LondonLondonUK
- National Institute for Health Research Health Protection Research Unit in Chemical and Radiation Threats and HazardsImperial College LondonLondonUK
- Mohn Centre for Children's Health and WellbeingSchool of Public HealthImperial College LondonLondonUK
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5
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Ma L, Liu X, Yan N, Gan Y, Wu Y, Li Y, Chu M, Chiu DT, Ma L. Associations Between Different Cortisol Measures and Adiposity in Children: A Systematic Review and Meta-Analysis. Front Nutr 2022; 9:879256. [PMID: 35811977 PMCID: PMC9260431 DOI: 10.3389/fnut.2022.879256] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2022] [Accepted: 05/30/2022] [Indexed: 12/12/2022] Open
Abstract
This study examined associations between hair, salivary, serum, and urinary cortisol concentration with adiposity-related indicators in children, and explored their potential effects modification by age, sex, cortisol measurement method, and country developmental context. We systematically searched PubMed, Web of Science, and Embase for studies examining at least one of the four aforementioned cortisol with objectively measured adiposity-related outcomes in children. Meta-analyses of cross-sectional studies revealed that hair cortisol concentration was associated with fat mass index (FMI)-standard deviation score (SDS)/FMI z-score (pooled-β = 0.04, 95% CI: 0.01, 0.08) and BMI/BMI z-score (pooled-β = 0.15, 95% CI: 0.06, 0.25), and these associations were significant among children aged ≤ 12 years (pooled-β = 0.15, 95% CI: 0.05, 0.26) and >12 years (pooled-β = 0.13, 95% CI: 0.04, 0.22), children from developed countries (pooled β = 0.12, 95% CI: 0.03, 0.21) and developing countries (pooled-β = 0.193, 95% CI: 0.188, 0.198), and in studies extracting cortisol via LC-MS/MS (pooled-β = 0.18, 95% CI: 0.06, 0.29) but not ELISA (pooled-β = 0.08, 95% CI: −0.06, 0.22). Meta-analyses of both cohort and cross-sectional studies revealed non-significant associations of morning salivary cortisol concentration and total daily cortisol output with BMI/BMI z-score. Serum cortisol concentration was not associated with BMI or waist circumference. Meta-analysis of urinary cortisol concentration and adiposity was hindered by insufficient data. These findings further corroborate understanding of chronic stress’ physiological contribution to increased pediatric obesity risk.
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Affiliation(s)
- Lu Ma
- School of Public Health, Global Health Institute, Xi’an Jiaotong University Health Science Center, Xi’an, China
| | - Xi Liu
- School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an, China
- The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Na Yan
- School of Public Health, Global Health Institute, Xi’an Jiaotong University Health Science Center, Xi’an, China
| | - Yiqun Gan
- Beijing Key Laboratory of Behavior and Mental Health, School of Psychological and Cognitive Sciences, Peking University, Beijing, China
| | - Yue Wu
- Department of Cardiology, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
- Key Laboratory of Environment and Genes Related to Diseases, Ministry of Education, Xi’an, China
- Key Laboratory of Molecular Cardiology, Xi’an, China
| | - Ying Li
- Department of Cardiology, The Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Meng Chu
- School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an, China
| | - Dorothy T. Chiu
- Community Health Sciences Division, School of Public Health, University of California, Berkeley, Berkeley, CA, United States
- *Correspondence: Dorothy T. Chiu,
| | - Le Ma
- School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an, China
- Le Ma,
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6
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Grimm J, Stemmler M, Golub Y, Schwenke E, Goecke TW, Fasching PA, Beckmann MW, Kratz O, Moll GH, Kornhuber J, Eichler A. The association between prenatal alcohol consumption and preschool child stress system disturbance. Dev Psychobiol 2020; 63:687-697. [PMID: 33012000 DOI: 10.1002/dev.22038] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Revised: 07/09/2020] [Accepted: 08/31/2020] [Indexed: 01/15/2023]
Abstract
BACKGROUND Drinking alcohol during pregnancy is considered a risk factor for child development; however, child biomarkers of prenatal alcohol exposure have been rarely studied. We examined whether a meconium alcohol metabolite (ethyl glucuronide, EtG) was associated with child cortisol concentrations at primary school age. METHODS For 137 children, prenatal alcohol exposure was operationalized by the meconium biomarker EtG and by maternal self-reports during pregnancy. Two EtG cut-offs (EtG ≥10 ng/g and EtG ≥112 ng/g) were applied. Cortisol concentrations were measured in saliva and hair samples. RESULTS Children with EtG ≥10 ng/g showed significantly reduced hair cortisol concentrations (HCCs) (p = .050, η p 2 = 0.042). For children with EtG ≥112 ng/g, the cortisol awakening response (CAR) was significantly decreased (p = .025, η p 2 = 0.070). These effects were also present in correlational analyses with continuous EtG data, speaking for partly dose-dependent effects. Especially, within the EtG ≥112 ng/g group, the basal (CAR: rp = -.642, p = .120) and cumulative (HCC: rp = -.660, p = .107) cortisol parameters were associated with child emotional symptoms at medium effect size. CONCLUSIONS The present study showed both the biological association of intrauterine alcohol exposure with the cortisol stress system, partly dose-dependent, and the functional association with emotional and behavioral symptoms.
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Affiliation(s)
- Jennifer Grimm
- Department of Child and Adolescent Mental Health, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
| | - Mark Stemmler
- Department of Psychology, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
| | - Yulia Golub
- Department of Child and Adolescent Mental Health, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany.,Department of Child and Adolescent Mental Health, Carl Gustav Carus University Hospital, Dresden, Germany
| | - Eva Schwenke
- Department of Obstetrics and Gynecology, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
| | - Tamme W Goecke
- Department of Obstetrics and Gynecology, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany.,RoMed Klinikum Rosenheim, Rosenheim, Germany
| | - Peter A Fasching
- Department of Obstetrics and Gynecology, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
| | - Matthias W Beckmann
- Department of Obstetrics and Gynecology, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
| | - Oliver Kratz
- Department of Child and Adolescent Mental Health, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
| | - Gunther H Moll
- Department of Child and Adolescent Mental Health, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
| | - Johannes Kornhuber
- Department of Psychiatry and Psychotherapy, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
| | - Anna Eichler
- Department of Child and Adolescent Mental Health, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
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7
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Ling J, Kao TSA, Robbins LB. Body mass index, waist circumference and body fat are positively correlated with hair cortisol in children: A systematic review and meta-analysis. Obes Rev 2020; 21:e13050. [PMID: 32543094 DOI: 10.1111/obr.13050] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Revised: 04/18/2020] [Accepted: 05/01/2020] [Indexed: 12/20/2022]
Abstract
The current body of research lacks a meta-analysis of the relationship between hair cortisol concentration (HCC) and anthropometry in children. Therefore, this systematic review and meta-analysis was conducted to examine this relationship and explore possible moderators between HCC and body mass index (BMI/BMI z-score). Eleven databases were searched: CINAHL, Cochrane, Embase, PsycEXTRA, Psychology and Behavioral Sciences, PsycINFO, PubMed, Scopus, Social Sciences Full Text, Sociological Abstracts and Web of Sciences. Random-effects models and exploratory moderator analyses with mixed-effects models were performed using the Comprehensive Meta-Analysis software. The meta-analysis showed small positive correlations between HCC and BMI (r = 0.08, 95% confidence interval [CI]: 0.02, 0.14, n = 18, p = .009), BMI z-score (r = 0.10, 95% CI: 0.03, 0.16, n = 12, p = .003), waist circumference (r = 0.10, 95% CI: 0.04, 0.17, n = 10, p = .001) and body fat including fat mass index (r = 0.06, 95% CI: 0.02, 0.11, n = 3, p = .005). The relationship between HCC and BMI/BMI z-score was significantly moderated by children's sex. Results from this meta-analysis provide initial objective support for a small positive relationship between HCC and anthropometric factors.
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Affiliation(s)
- Jiying Ling
- College of Nursing, Michigan State University, East Lansing, Michigan, USA
| | - Tsui-Sui Annie Kao
- College of Nursing, Michigan State University, East Lansing, Michigan, USA
| | - Lorraine B Robbins
- College of Nursing, Michigan State University, East Lansing, Michigan, USA
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8
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Bani-Issa W, Radwan H, Al Marzooq F, Al Awar S, Al-Shujairi AM, Samsudin AR, Khasawneh W, Albluwi N. Salivary Cortisol, Subjective Stress and Quality of Sleep Among Female Healthcare Professionals. J Multidiscip Healthc 2020; 13:125-140. [PMID: 32103972 PMCID: PMC7008192 DOI: 10.2147/jmdh.s229396] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2019] [Accepted: 01/08/2020] [Indexed: 12/29/2022] Open
Abstract
Background Stress is globally recognised as a risk factor impacting workers’ health and workplace safety. Women healthcare professionals are at risk for considerable stress given the demanding nature of their jobs and current working conditions. This study assessed levels of stress among women healthcare professionals using measures of their cortisol levels, subjective stress and quality of sleep. Participants and Methods This study used a cross-sectional design. Data were collected from 335 apparently healthy adult women healthcare professionals working in the United Arab Emirates. Participants provided morning and bedtime saliva samples for analysis of their cortisol levels. The Perceived Stress Scale, Stress Symptoms Scale, Brief Coping Scale and Pittsburgh Sleep Quality Index were used to assess perceived stress level, symptoms of stress, stress-coping strategies and sleep quality, respectively. Results In total, 121 (36.15%) women had impaired morning cortisol levels (below the normal range of 0.094–1.551 µg/dL) and 48 (14.3%) had impaired bedtime cortisol levels (above 0.359 µg/dL). Around 57% of women reported moderate levels of perceived stress, with the most frequently reported stress symptoms being heart rate and back/neck pain. Poor sleep quality was reported by around 60% of participating women. No significant association was found between cortisol and psychosocial measurements of stress or sleep quality. However, night shift and longer shift duration (more than 8 hrs) were significantly associated with impaired morning and bedtime cortisol levels (P ≥ 0.05). Impaired cortisol levels were strongly dependent on using adaptive coping strategies such as active coping, acceptance and seeking emotional support (P ≥ 0.05). Conclusion Evaluating cortisol levels and subjective stress could help to identify groups with impaired response to stress and elevated cortisol levels. Our findings support the need to examine shift work patterns and stress coping strategies in women healthcare professionals to promote their health and productivity and maintain workplace safety.
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Affiliation(s)
- Wegdan Bani-Issa
- Sharjah Institute for Medical Research, College of Health Sciences, Department of Nursing, University of Sharjah, Sharjah, United Arab Emirates
| | - Hadia Radwan
- College of Health Sciences, Clinical Nutrition and Dietetics, University of Sharjah, Sharjah, United Arab Emirates
| | - Farah Al Marzooq
- Sharjah Institute for Medical Research, University of Sharjah, Sharjah, United Arab Emirates
| | - Shamsa Al Awar
- Department of Obstetrics and Gynaecology, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Arwa M Al-Shujairi
- Research Institute of Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
| | - Ab Rani Samsudin
- College of Dental Medicine, Oral and Craniofacial Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
| | | | - Najla Albluwi
- Research Institute of Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
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9
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Werbinski JL, Rojek MK, Cabral MDI. The Need to Integrate Sex and Gender Differences into Pediatric Pedagogy. Adv Pediatr 2019; 66:15-35. [PMID: 31230691 DOI: 10.1016/j.yapd.2019.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- Janice L Werbinski
- Department of Obstetrics and Gynecology, Western Michigan University Homer Stryker MD School of Medicine, 1000 Oakland Drive, Kalamazoo, MI 49008-1284, USA.
| | - Mary K Rojek
- Sex and Gender Health Collaborative, American Medical Women's Association, 1100 Woodfield Rd. #350, Schaumburg, IL 60173, USA
| | - Maria Demma I Cabral
- Department of Pediatric and Adolescent Medicine, Western Michigan University Homer Stryker MD School of Medicine, 1000 Oakland Drive, Kalamazoo, MI 49008-1284, USA
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10
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Prado-Gascó V, de la Barrera U, Sancho-Castillo S, de la Rubia-Ortí JE, Montoya-Castilla I. Perceived stress and reference ranges of hair cortisol in healthy adolescents. PLoS One 2019; 14:e0214856. [PMID: 30947316 PMCID: PMC6448926 DOI: 10.1371/journal.pone.0214856] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2018] [Accepted: 03/21/2019] [Indexed: 12/11/2022] Open
Abstract
Background Chronic stress during adolescence has usually been evaluated through subjective measures, leaving aside objective measures such as hair cortisol concentrations. Therefore, the aim of this study was to provide reference ranges for hair cortisol concentrations by sex and age and to study the relationship between subjective and objective measures of stress and temporal stability. Methods The participants were 170 adolescents aged between 12 and 14 years (mean = 12.78 years; standard deviation = 0.71 years; 52.40% girls) who completed the Perceived Stress Scale 4 and had their hair sampled. Results The results revealed hair cortisol concentrations ranging from 0.07 pg/mg to 9.54 pg/mg. Subjective and objective measures of stress were not related, nor was there intraindividual stability of the hair cortisol concentrations. Girls had higher hair cortisol concentrations, and there were no age differences. Conclusions This research provides cortisol reference values for adolescents that will allow the early detection of chronic stress. Such detection methods make it possible to prevent problems arising from stress because we can act more quickly and the treatments will be more effective. The study suggests that there is no relationship between perceived and objective stress; while perceived stress remained stable, the levels of hair cortisol were increased at 6 months. Despite the interesting findings of the study, there are some limitations: the sample was not obtained through probabilistic sampling, the age range was narrow, and some demographic, anthropomorphic and clinical factors are missing, which make the generalization of results difficult.
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Affiliation(s)
| | - Usue de la Barrera
- Department of Personality, Assessment and Psychological Treatment, University of Valencia, Valencia, Spain
| | | | | | - Inmaculada Montoya-Castilla
- Department of Personality, Assessment and Psychological Treatment, University of Valencia, Valencia, Spain
- * E-mail:
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