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Kassis W, Aksoy D, Favre CA, Arnold J, Gaugler S, Grafinger KE, Artz S, Magnuson D. On the complex relationship between resilience and hair cortisol levels in adolescence despite parental physical abuse: a fourth wave of resilience research. Front Psychiatry 2024; 15:1345844. [PMID: 38628259 PMCID: PMC11019004 DOI: 10.3389/fpsyt.2024.1345844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Accepted: 03/20/2024] [Indexed: 04/19/2024] Open
Abstract
Introduction To understand the family's role in adolescents' mental health development and the connection to neurodevelopmental disorders related to experienced parental physical abuse, we first explored resilience pathways longitudinally and secondly, connected the identified patterns to adolescents' hair cortisol levels that are rooted in the hypothalamic-pituitary-adrenal axis as the main stress response system and connected brain structure alterations. Methods We analyzed longitudinal online questionnaire data for three consecutive high school years (from seventh to ninth grade) and four survey waves from a representative sample of n = 1609 high school students in Switzerland on violence-resilience pathways. Furthermore, we collected students' hair samples from a subsample of n = 229 at survey wave 4. About 30% of the participating adolescents had been physically abused by their parents. Out of the overall sample, we drew a subsample of adolescents with parental abuse experiences (survey wave 1 n = 509; survey wave 2 n = 506; survey wave 3 n = 561; survey wave 4 n = 560). Results Despite the odds, about 20-30% of adolescents who have experienced parental physical abuse escaped the family violence cycle and can be called resilient. By applying a person-oriented analytical approach via latent class and transition analysis, we longitudinally identified and compared four distinct violence-resilience patterns. We identified violence resilience as a multidimensional latent construct, which includes hedonic and eudaimonic protective and risk indicators. Because resilience should not solely be operationalized based on the lack of psychopathology, our latent construct included both feeling good (hedonic indicators such as high levels of self-esteem and low levels of depression/anxiety and dissociation) and doing well (eudaimonic indicators such as high levels of self-determination and self-efficacy as well as low levels of aggression toward peers). Discussion The present study confirmed that higher cortisol levels significantly relate to the comorbid pattern (internalizing and externalizing symptoms), and further confirmed the presence of lasting alterations in brain structures. In this way, we corroborated the insight that when studying the resilience pathways and trajectories of abused adolescents, biological markers such as hair cortisol significantly enhance and deepen the understanding of the longitudinal mechanisms of psychological markers (e.g., self-determination, self-esteem, self-efficacy) that are commonly applied in questionnaires.
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Affiliation(s)
- Wassilis Kassis
- School of Education, University of Applied Sciences, Windisch, Switzerland
| | - Dilan Aksoy
- School of Education, University of Applied Sciences, Windisch, Switzerland
| | - Céline Anne Favre
- School of Education, University of Applied Sciences, Windisch, Switzerland
| | - Julia Arnold
- School of Education, University of Applied Sciences, Windisch, Switzerland
| | - Stefan Gaugler
- School of Life Sciences, University of Applied Sciences, Muttenz, Switzerland
| | | | - Sibylle Artz
- School of Child and Youth Care, University of Victoria, Victoria, BC, Canada
| | - Doug Magnuson
- Educational Psychology and Leadership Studies, University of Victoria, Victoria, BC, Canada
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Nyengaard R, Kallesøe KH, Rimvall MK, Ørnbøl E, Wellnitz KB, Olsen EM, Wyller VBB, Rask CU. Hair cortisol and self-perceived stress in adolescents with multi-system functional somatic disorders. BMC Psychiatry 2024; 24:101. [PMID: 38317120 PMCID: PMC10840144 DOI: 10.1186/s12888-024-05518-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Accepted: 01/11/2024] [Indexed: 02/07/2024] Open
Abstract
BACKGROUND Long-term stress causing altered hypothalamic-pituitary-adrenal (HPA) axis dynamics with cortisol dysfunction may be involved in the pathophysiology of functional somatic disorders (FSD), but studies on adolescents with multi-system FSD are lacking. Therefore, we investigated: 1) whether hair cortisol concentration (HCC) differentiates adolescents with multi-system FSD from a) a population-based sample and b) a subgroup derived from the sample reporting a high physical symptom load, and 2) whether FSD population HCC is associated with primary symptom presentations and self-perceived stress. METHODS We used data from a clinical sample with multi-system FSD (N = 91, age 15-19 years) and a population-based sample (N = 1,450, age 16-17 years) including a subgroup with top 10% total scores on physical symptoms (N = 147). Density plots and multiple linear regression were applied to compare HCC between groups. In the clinical sample, multiple linear regression was employed to assess the association between HCC and primary symptom clusters and self-perceived stress. RESULTS Median HCC was lower in the clinical sample than in the population-based sample (β = 0.80 (95%CI: 0.66, 0.97)), but not significantly different from median HCC in the derived subgroup (β = 0.84 (95%CI: 0.66, 1.07)). In the clinical sample, HCC was not significantly associated with primary symptom clusters (F(2, 82) = 0.13, p = 0.88) or self-perceived stress (F(4, 83) = 1.18, p = 0.33). CONCLUSION Our findings indicate that HCC is lowered in adolescents with multi-system FSD but not significantly associated with primary symptom presentations or self-perceived stress. Future studies including multiple measures of HPA axis dynamics alongside psychological measures may further elucidate the role of long-term stress in FSD. TRIAL REGISTRATION The AHEAD study was pre-registered at ClinicalTrials.gov (NCT02346071), 26/01/2015.
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Affiliation(s)
- Rebecca Nyengaard
- Research Unit Department of Child and Adolescent Psychiatry, Psychiatry, Aarhus University Hospital, Palle Juul-Jensens Boulevard 175, Aarhus N, 8200, Denmark
- Department of Clinical Medicine, Aarhus University, Incuba Skejby, building 2, Palle Juul-Jensens Boulevard 82, 8200, Aarhus N, Denmark
| | - Karen Hansen Kallesøe
- Research Unit Department of Child and Adolescent Psychiatry, Psychiatry, Aarhus University Hospital, Palle Juul-Jensens Boulevard 175, Aarhus N, 8200, Denmark.
| | - Martin Køster Rimvall
- Child and Adolescent Mental Health Centre, Mental Health Services in the Capital Region of Denmark, Kildegaardsvej 28, Entrance 3A, 1st Floor, 2900, Hellerup, Denmark
- Department of Child and Adolescent Psychiatry, Psychiatry Region Zealand, Ny Østergade 12, 4000, Roskilde, Denmark
| | - Eva Ørnbøl
- Department of Clinical Medicine, Aarhus University, Incuba Skejby, building 2, Palle Juul-Jensens Boulevard 82, 8200, Aarhus N, Denmark
- Research Clinic for Functional Disorders and Psychosomatics, Aarhus University Hospital, Palle Juul-Jensens Boulevard 11, Aarhus N, 8200, Denmark
| | - Kaare Bro Wellnitz
- Department of Clinical Medicine, Aarhus University, Incuba Skejby, building 2, Palle Juul-Jensens Boulevard 82, 8200, Aarhus N, Denmark
- Research Clinic for Functional Disorders and Psychosomatics, Aarhus University Hospital, Palle Juul-Jensens Boulevard 11, Aarhus N, 8200, Denmark
| | - Else Marie Olsen
- Centre for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, Ndr. Fasanvej 57, 1st Floor, Building 14, 2000, Frederiksberg, Denmark
- Psychiatric Centre Ballerup, Mental Health Services in the Capital Region of Denmark, Maglevænget 2, 2750, Ballerup, Denmark
| | - Vegard Bruun Bratholm Wyller
- Department of Pediatric and Adolescent Medicine, Akershus University Hospital, Postboks 1000, 1478, Lørenskog, Norway
- Institute of Clinical Medicine, University of Oslo, Blindern, P.O box 1171, 0318, Oslo, Norway
| | - Charlotte Ulrikka Rask
- Research Unit Department of Child and Adolescent Psychiatry, Psychiatry, Aarhus University Hospital, Palle Juul-Jensens Boulevard 175, Aarhus N, 8200, Denmark
- Department of Clinical Medicine, Aarhus University, Incuba Skejby, building 2, Palle Juul-Jensens Boulevard 82, 8200, Aarhus N, Denmark
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Yirmiya K, Motsan S, Zagoory-Sharon O, Schonblum A, Koren L, Feldman R. Continuity of psychopathology v. resilience across the transition to adolescence: role of hair cortisol and sensitive caregiving. Psychol Med 2023; 53:4487-4498. [PMID: 35634966 PMCID: PMC10388331 DOI: 10.1017/s0033291722001350] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2021] [Revised: 04/20/2022] [Accepted: 04/25/2022] [Indexed: 01/04/2023]
Abstract
BACKGROUND The transition to adolescence implicates heightened vulnerability alongside increased opportunities for resilience. Contexts of early life stress (ELS) exacerbate risk; still, little research addressed biobehavioral mediators of risk and resilience across the adolescent transition following ELS. Utilizing a unique cohort, we tested biosocial moderators of chronicity in adolescents' internalizing disorders v. resilience. METHOD Families exposed to chronic war-related trauma, v. controls, were followed. We utilized data from three time-points framing the adolescent transition: late childhood (N = 177, Mage = 9.3 years ± 1.41), early adolescence (N = 111, Mage = 11 0.66 years ± 1.23), and late adolescence (N = 138, Mage = 15.65 years ± 1.31). In late childhood and late adolescence children's internalizing disorders were diagnosed. At early adolescence maternal and child's hair cortisol concentrations (HCC), maternal sensitivity, and mothers' post-traumatic symptoms evaluated. RESULTS War-exposed children exhibited more internalizing disorders of chronic trajectory and mothers were less sensitive and more symptomatic. Three pathways elucidated the continuity of psychopathology: (a) maternal sensitivity moderated the risk of chronic psychopathology, (b) maternal post-traumatic symptoms mediated continuity of risk, (c) trauma exposure moderated the association between child internalizing disorders at late childhood and maternal HCC, which linked with child HCC. Child HCC linked with maternal post-traumatic symptoms, which were associated with child disorders in late adolescence. CONCLUSION Results demonstrate the complex interplay of maternal and child's biosocial factors as mediators and moderators of risk chronicity across the adolescent transition following trauma. Findings are first to utilize maternal and child's HCC as biomarkers of chronic stress v. resilience during adolescence, a period of neural reorganization and personal growth that shapes the individual's lifetime adaptation.
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Affiliation(s)
- Karen Yirmiya
- Baruch Ivcher School of Psychology, Reichman University, Herzliya, Israel
| | - Shai Motsan
- Baruch Ivcher School of Psychology, Reichman University, Herzliya, Israel
| | | | - Anat Schonblum
- Faculty of Life Sciences, Bar-Ilan University, Ramat Gan, Israel
| | - Lee Koren
- Faculty of Life Sciences, Bar-Ilan University, Ramat Gan, Israel
| | - Ruth Feldman
- Baruch Ivcher School of Psychology, Reichman University, Herzliya, Israel
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Smaliukienė R, Bekesiene S, Mažeikienė A, Larsson G, Karčiauskaitė D, Mazgelytė E, Vaičaitienė R. Hair Cortisol, Perceived Stress, and the Effect of Group Dynamics: A Longitudinal Study of Young Men during Compulsory Military Training in Lithuania. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031663. [PMID: 35162686 PMCID: PMC8835136 DOI: 10.3390/ijerph19031663] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Revised: 01/27/2022] [Accepted: 01/28/2022] [Indexed: 12/19/2022]
Abstract
Previous research shows a nonlinear dependency between hair cortisol concentrations and perceived stress levels. This may be due to stress being targeted at the individual level despite it also being a social phenomenon which is often affected by group dynamics. Therefore, the objective of this study was to determine the influence of perceived stress on the hair cortisol level, considering the impact of the variables of group dynamics (interpersonal, task, and norm cohesion). Information was collected on 11 groups of, in total, 112 young men in three phases of time during their compulsory military training (covering nine months in total). The classification and regression tree (C&RT) method was used to predict hair cortisol concentrations in groups. The results show that the variability of the hair cortisol level in young men groups can be explained by perceived stress only when the groups were in formation process (47.7% normalised importance in Model 1) and when the groups were working on their final tasks (37.80% normalised importance in Model 3); meanwhile, the importance of perceived stress in explaining hair cortisol concentrations is low when the group is in a routine period of a group life-span (28.9% normalised importance in Model 2). Interpersonal cohesion (normalised importance 100% in Model 1 and 80.0% in Model 3) and task cohesion (normalised importance 78.6% in Model 2) were the most important predictors in the study area. These results point to the importance of the elements of group dynamics when it comes to explaining the nature of hair cortisol as accumulated stress biomarkers in young men.
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Affiliation(s)
- Rasa Smaliukienė
- General Jonas Zemaitis Military Academy of Lithuania, Silo 5a, LT-10322 Vilnius, Lithuania; (S.B.); (R.V.)
- Department of Creative Communication, Vilnius Gediminas Technical University, Saulėtekio al. 11, LT-10223 Vilnius, Lithuania
- Correspondence:
| | - Svajone Bekesiene
- General Jonas Zemaitis Military Academy of Lithuania, Silo 5a, LT-10322 Vilnius, Lithuania; (S.B.); (R.V.)
| | - Asta Mažeikienė
- Microbiology and Laboratory Medicine, Department of Physiology, Biochemistry, Institute of Biomedical Sciences, Faculty of Medicine, Vilnius University, M. K. Čiurlionio st. 21, LT-03101 Vilnius, Lithuania; (A.M.); (G.L.); (D.K.); (E.M.)
| | - Gerry Larsson
- Microbiology and Laboratory Medicine, Department of Physiology, Biochemistry, Institute of Biomedical Sciences, Faculty of Medicine, Vilnius University, M. K. Čiurlionio st. 21, LT-03101 Vilnius, Lithuania; (A.M.); (G.L.); (D.K.); (E.M.)
- Department of Security, Strategy and Leadership (ISSL), Swedish Defence University, Karlstad, Drottning Kristinas väg 37, 114 28 Stockholm, Sweden
- Department of Public Health, Inland University College of Applied Sciences, Hamarvegen 112, 2406 Elverum, Norway
| | - Dovilė Karčiauskaitė
- Microbiology and Laboratory Medicine, Department of Physiology, Biochemistry, Institute of Biomedical Sciences, Faculty of Medicine, Vilnius University, M. K. Čiurlionio st. 21, LT-03101 Vilnius, Lithuania; (A.M.); (G.L.); (D.K.); (E.M.)
| | - Eglė Mazgelytė
- Microbiology and Laboratory Medicine, Department of Physiology, Biochemistry, Institute of Biomedical Sciences, Faculty of Medicine, Vilnius University, M. K. Čiurlionio st. 21, LT-03101 Vilnius, Lithuania; (A.M.); (G.L.); (D.K.); (E.M.)
| | - Ramutė Vaičaitienė
- General Jonas Zemaitis Military Academy of Lithuania, Silo 5a, LT-10322 Vilnius, Lithuania; (S.B.); (R.V.)
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Verheyen VJ, Remy S, Govarts E, Colles A, Koppen G, Martin LR, Nielsen F, Bruckers L, Bijnens EM, Vos S, Morrens B, Coertjens D, Loots I, De Decker A, Franken C, Den Hond E, Nelen V, De Henauw S, Covaci A, Van Larebeke N, Teughels C, Nawrot TS, Schoeters G. Determinants of Chronic Biological Stress, Measured as Hair Cortisol Concentration, in a General Population of Adolescents: From Individual and Household Characteristics to Neighborhood Urbanicity. Front Public Health 2021; 9:669022. [PMID: 34888272 PMCID: PMC8650704 DOI: 10.3389/fpubh.2021.669022] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Accepted: 10/14/2021] [Indexed: 11/13/2022] Open
Abstract
Chronic biological stress may adversely affect adolescents' physical and mental health, but insight in the personal and environmental factors that determine chronic stress is limited. We measured 3-month cumulative hair cortisol concentration (HCC) in 419 adolescents, participating in the Flemish Environment and Health Study. Adolescents' health and lifestyle characteristics, household and neighborhood socio-economic status as well as neighborhood urbanicity were assessed as potential determinants of HCC, using multiple linear regression models. We additionally explored heterogeneity of our results by sex. HCC were significantly higher in boys from densely populated neighborhoods, the association was not significant in girls. Accordingly, boys living outside cities had significantly lower HCC than boys, living in cities. HCC was significantly lower in adolescents with an optimal vitality, a measure of a positive mental health status. In adolescent girls, menarcheal status (pre-/postmenarche) was a significant determinant of HCC. Our findings are the first to suggest that residential urbanicity may have an impact on chronic biological stress in a general population of adolescent boys.
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Affiliation(s)
- Veerle J Verheyen
- VITO Health, Flemish Institute for Technological Research (VITO), Antwerp, Belgium.,Department of Biomedical Sciences, University of Antwerp, Antwerp, Belgium
| | - Sylvie Remy
- VITO Health, Flemish Institute for Technological Research (VITO), Antwerp, Belgium
| | - Eva Govarts
- VITO Health, Flemish Institute for Technological Research (VITO), Antwerp, Belgium
| | - Ann Colles
- VITO Health, Flemish Institute for Technological Research (VITO), Antwerp, Belgium
| | - Gudrun Koppen
- VITO Health, Flemish Institute for Technological Research (VITO), Antwerp, Belgium
| | | | - Flemming Nielsen
- Institute of Public Health, Department of Environmental Medicine, University of Southern Denmark, Odense, Denmark
| | - Liesbeth Bruckers
- I-BioStat, Data Science Institute, Hasselt University, Hasselt, Belgium
| | - Esmée M Bijnens
- Centre for Environmental Sciences, Hasselt University, Hasselt, Belgium
| | - Stijn Vos
- Centre for Environmental Sciences, Hasselt University, Hasselt, Belgium
| | - Bert Morrens
- Department of Sociology, Faculty of Social Sciences, University of Antwerp, Antwerp, Belgium
| | - Dries Coertjens
- Department of Sociology, Faculty of Social Sciences, University of Antwerp, Antwerp, Belgium
| | - Ilse Loots
- Department of Sociology, Faculty of Social Sciences, University of Antwerp, Antwerp, Belgium
| | - Annelies De Decker
- Provincial Institute of Hygiene, Provincial Research Centre for Environment and Health, Antwerp, Belgium
| | - Carmen Franken
- Provincial Institute of Hygiene, Provincial Research Centre for Environment and Health, Antwerp, Belgium
| | - Elly Den Hond
- Provincial Institute of Hygiene, Provincial Research Centre for Environment and Health, Antwerp, Belgium
| | - Vera Nelen
- Provincial Institute of Hygiene, Provincial Research Centre for Environment and Health, Antwerp, Belgium
| | - Stefaan De Henauw
- Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Adrian Covaci
- Toxicological Centre, University of Antwerp, Antwerp, Belgium
| | - Nicolas Van Larebeke
- Analytical, Environmental and Geo-Chemistry, Vrije Universiteit Brussel, Brussels, Belgium.,Department of Radiotherapy and Experimental Cancerology, Ghent University, Ghent, Belgium
| | - Caroline Teughels
- Flemish Planning Bureau for the Environment and Spatial Development, Brussels, Belgium
| | - Tim S Nawrot
- Centre for Environmental Sciences, Hasselt University, Hasselt, Belgium
| | - Greet Schoeters
- VITO Health, Flemish Institute for Technological Research (VITO), Antwerp, Belgium.,Department of Biomedical Sciences, University of Antwerp, Antwerp, Belgium
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Wu J, Tong H, Liu Z, Tao J, Chen L, Chan CCH, Lee TMC. Neurobiological effects of perceived stress are different between adolescents and middle-aged adults. Brain Imaging Behav 2021; 15:846-854. [PMID: 32737826 PMCID: PMC8032601 DOI: 10.1007/s11682-020-00294-7] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Stress is an inevitable element of everyday living. Developmental studies suggested that adolescents are more vulnerable and sensitive to the effect of stress due to their developing brains, especially in areas related to stress perception and processing. This voxel-based morphometry study examined the association between various neurobiological markers and the level of perceived stress experienced by adolescents (n = 26) and middle-aged adults (n = 26). Our findings indicated that differences existed in the relationships between perceived stress and the structural volume of the orbitofrontal cortex (OFC) extending to the insula and amygdala. Specifically, the levels of perceived stress and the grey matter volume of the orbitofrontal cortex, the insula, and the amygdala were positively related in adolescents but negatively related for adults. Furthermore, a significant negative correlation between perceived stress and cortisol levels was observed in adults, whereas the relationship between perceived stress and cortisol levels was not significant for adolescents. Perceived stress measurement may be better than cortisol levels in terms of reflecting the emotional states of adolescents. In sum, the relationships between perceived stress and neurobiological markers were different between adolescents and middle-aged adults and thus appeared to be age dependent.
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Affiliation(s)
- Jingsong Wu
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Horace Tong
- Brain Hospital, Guangzhou Medical University, Guangzhou, China
- State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong, China
- Laboratory of Neuropsychology and Human Neuroscience, The University of Hong Kong, Hong Kong, China
| | - Zhongwan Liu
- Brain Hospital, Guangzhou Medical University, Guangzhou, China
- State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong, China
- Laboratory of Neuropsychology and Human Neuroscience, The University of Hong Kong, Hong Kong, China
| | - Jing Tao
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Lidian Chen
- Fujian University of Traditional Chinese Medicine, No. 1 Huatuo Road Shangjie Minhou, Fuzhou, 350122, China.
| | - Chetwyn C H Chan
- Applied Cognitive Neuroscience Laboratory, Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China.
| | - Tatia M C Lee
- Brain Hospital, Guangzhou Medical University, Guangzhou, China.
- State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong, China.
- Laboratory of Neuropsychology and Human Neuroscience, The University of Hong Kong, Hong Kong, China.
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Infortuna C, Gratteri F, Benotakeia A, Patel S, Fleischman A, Muscatello MRA, Bruno A, Zoccali RA, Chusid E, Han Z, Battaglia F. Exploring the Gender Difference and Predictors of Perceived Stress among Students Enrolled in Different Medical Programs: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17186647. [PMID: 32933068 PMCID: PMC7558788 DOI: 10.3390/ijerph17186647] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/26/2020] [Revised: 08/27/2020] [Accepted: 08/30/2020] [Indexed: 01/02/2023]
Abstract
Female medical students seem to experience higher level of perceived stress. Moreover, there is a lack of research examining perceived stress in students enrolled in different medical programs. We analyzed the association between temperament traits, optimism, self-esteem, and perceived stress of students pursuing a Doctor of Medicine (MD) degree and students pursuing a Doctor of Podiatric Medicine (DPM) degree. A cross-sectional study was conducted of two cohorts: allopathic medical students (N = 154) and the podiatric medical students (N = 150). Students anonymously completed the Perceived Stress Scale (PSS-10), Temperament Evaluation of Memphis, Pisa, Paris, and San Diego Auto Questionnaire (TEMPS-A), Rosenberg Self-Esteem Scale, and Life Orientation Test—Revised (LOT-R). We analyzed differences in the two cohort of students and predictors of perceived stress. There were no differences in the overall perception of stress between both cohorts (allopathic medical students: 18.83 ± 0.56; podiatric medical students: 19.3 ± 0.72; p = 0.4419). Women reported higher perceived stress in both programs (allopathic medical students: p = 0.0.038; podiatric medical students: p = 0.0.038). In both allopathic and podiatric medical students, the cyclothymic temperaments and anxious traits were positive predictors while hyperthymic temperaments and optimism traits were negative predictors of perceived stress. The level of perceived stress experienced by students pursuing different doctoral degrees in healthcare is similar. Regardless of the curriculum differences, female students experience higher perceived stress and there is evidence for similarities in predictors amongst allopathic and podiatric medical students.
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Affiliation(s)
- Carmenrita Infortuna
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Policlinico Universitario, University of Messina, 98124 Messina, Italy; (C.I.); (F.G.); (M.R.A.M.); (A.B.); (R.A.Z.)
| | - Francesco Gratteri
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Policlinico Universitario, University of Messina, 98124 Messina, Italy; (C.I.); (F.G.); (M.R.A.M.); (A.B.); (R.A.Z.)
| | - Andrew Benotakeia
- Department of Medical Sciences and Neurology, Hackensack Meridian School of Medicine at Seton Hall University, Nutley, NJ 07110, USA; (A.B.); (Z.H.)
| | - Sapan Patel
- Department of Pre-Clinical Sciences, New York College of Podiatric Medicine, New York, NY 10035, USA; (S.P.); (A.F.); (E.C.)
| | - Alex Fleischman
- Department of Pre-Clinical Sciences, New York College of Podiatric Medicine, New York, NY 10035, USA; (S.P.); (A.F.); (E.C.)
| | - Maria Rosaria Anna Muscatello
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Policlinico Universitario, University of Messina, 98124 Messina, Italy; (C.I.); (F.G.); (M.R.A.M.); (A.B.); (R.A.Z.)
| | - Antonio Bruno
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Policlinico Universitario, University of Messina, 98124 Messina, Italy; (C.I.); (F.G.); (M.R.A.M.); (A.B.); (R.A.Z.)
| | - Rocco Antonio Zoccali
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Policlinico Universitario, University of Messina, 98124 Messina, Italy; (C.I.); (F.G.); (M.R.A.M.); (A.B.); (R.A.Z.)
| | - Eileen Chusid
- Department of Pre-Clinical Sciences, New York College of Podiatric Medicine, New York, NY 10035, USA; (S.P.); (A.F.); (E.C.)
| | - Zhiyong Han
- Department of Medical Sciences and Neurology, Hackensack Meridian School of Medicine at Seton Hall University, Nutley, NJ 07110, USA; (A.B.); (Z.H.)
| | - Fortunato Battaglia
- Department of Medical Sciences and Neurology, Hackensack Meridian School of Medicine at Seton Hall University, Nutley, NJ 07110, USA; (A.B.); (Z.H.)
- Correspondence: ; Tel.: +1-9737619605
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Berger M, Taylor S, Harriss L, Campbell S, Thompson F, Jones S, Sushames A, Amminger GP, Sarnyai Z, McDermott R. Hair cortisol, allostatic load, and depressive symptoms in Australian Aboriginal and Torres Strait Islander people. Stress 2019; 22:312-320. [PMID: 30835590 DOI: 10.1080/10253890.2019.1572745] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Chronic stress and adversity are associated with poor mental health and are thought to contribute to the existing mental health gap between Aboriginal and Torres Strait Islander people and other Australians. Hair cortisol and allostatic load (AL) are indices of sustained stress and may be mediators of the effects of stress on health. The aim of this study was to examine the relationship between hair cortisol, AL, and depressive symptoms. This cross-sectional study comprised 329 Aboriginal and Torres Strait Islander adolescents and adults recruited at two health screening programs operating in three communities in north Queensland. We measured hair cortisol and calculated an AL index from 10 biomarkers. We assessed depressive symptoms with a version of the Patient Health Questionnaire-9 adapted for Aboriginal and Torres Strait Islander people (aPHQ-9). We found differences in cortisol and AL between the screening programs and communities, which were not explained by depressive symptoms. Overall aPHQ-9 scores were unrelated to hair cortisol (p = .25 and p = .94) and AL (p = .30 and p = .88) when age, gender and smoking were taken into account. However, anhedonia (p = .007) and insomnia (p = .006) sub-scores were each significantly associated with AL in one study site. Our present data did not demonstrate overall associations of stress biomarkers and multisystem dysregulation with depressive symptoms, which suggests that the relationship between cumulative stress and depression may be better explained by other factors in this population. The specific association between anhedonia and insomnia with AL indicates that chronic multisystem dysregulation plays a role in these features of depression in this population. Lay summary Our study investigated the relationship between symptoms of depression and two biological pathways thought to mediate depression risk - the stress hormone cortisol and allostatic load (AL) - in an Australian Aboriginal and Torres Strait Islander population. Overall, cortisol and AL were unrelated to depression. However, AL was selectively associated with anhedonia (lack of motivation or drive) and sleep disturbances. These results suggest that metabolic dysregulation measured as AL may be relevant to the depression risk in this population.
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Affiliation(s)
- Maximus Berger
- a College of Public Health, Medical and Veterinary Sciences , Centre for Chronic Disease Prevention, Australian Institute of Tropical Health and Medicine (AITHM), James Cook University , Cairns , Australia
- b College of Public Health, Medical and Veterinary Sciences, Laboratory of Psychiatric Neuroscience , Australian Institute of Tropical Health and Medicine (AITHM), James Cook University , Townsville , Australia
- c The National Centre of Excellence in Youth Mental Health, Orygen , Melbourne , Australia
| | - Sean Taylor
- a College of Public Health, Medical and Veterinary Sciences , Centre for Chronic Disease Prevention, Australian Institute of Tropical Health and Medicine (AITHM), James Cook University , Cairns , Australia
| | - Linton Harriss
- a College of Public Health, Medical and Veterinary Sciences , Centre for Chronic Disease Prevention, Australian Institute of Tropical Health and Medicine (AITHM), James Cook University , Cairns , Australia
| | - Sandra Campbell
- a College of Public Health, Medical and Veterinary Sciences , Centre for Chronic Disease Prevention, Australian Institute of Tropical Health and Medicine (AITHM), James Cook University , Cairns , Australia
| | - Fintan Thompson
- a College of Public Health, Medical and Veterinary Sciences , Centre for Chronic Disease Prevention, Australian Institute of Tropical Health and Medicine (AITHM), James Cook University , Cairns , Australia
| | - Samuel Jones
- d Torres and Cape Hospital and Health Service , Thursday Island , Australia
| | - Ashleigh Sushames
- a College of Public Health, Medical and Veterinary Sciences , Centre for Chronic Disease Prevention, Australian Institute of Tropical Health and Medicine (AITHM), James Cook University , Cairns , Australia
| | - G Paul Amminger
- c The National Centre of Excellence in Youth Mental Health, Orygen , Melbourne , Australia
| | - Zoltan Sarnyai
- b College of Public Health, Medical and Veterinary Sciences, Laboratory of Psychiatric Neuroscience , Australian Institute of Tropical Health and Medicine (AITHM), James Cook University , Townsville , Australia
| | - Robyn McDermott
- a College of Public Health, Medical and Veterinary Sciences , Centre for Chronic Disease Prevention, Australian Institute of Tropical Health and Medicine (AITHM), James Cook University , Cairns , Australia
- e School of Health Sciences , University of South Australia , Adelaide , Australia
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Wu YK, Berry DC, Schwartz TA. Weight stigma and acculturation in relation to hair cortisol among Asian Americans with overweight and obesity: A cross-sectional study. Health Psychol Open 2019; 6:2055102919829275. [PMID: 30800411 PMCID: PMC6378445 DOI: 10.1177/2055102919829275] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Weight stigma is a pervasive problem for Americans, but little is known about its impact on the health of Asian Americans. Authors examined the relationship between weight stigma and cortisol and whether acculturation moderated this relationship. Asian Americans (n = 166) with overweight or obesity completed questionnaires and provided a 50-mg hair sample to assay cortisol. Results revealed a negative correlation between weight stigma and cortisol. However, this was no longer significant after controlling of relevant covariates. The level of acculturation did not significantly moderate this relationship. The non-significant relationships among weight stigma, cortisol, and acculturation are discussed along with future directions.
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Affiliation(s)
- Ya-Ke Wu
- The University of North Carolina at Chapel Hill, USA
| | - Diane C Berry
- The University of North Carolina at Chapel Hill, USA
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10
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Liu CH, Doan SN. Innovations in biological assessments of chronic stress through hair and nail cortisol: Conceptual, developmental, and methodological issues. Dev Psychobiol 2019; 61:465-476. [PMID: 30740655 DOI: 10.1002/dev.21830] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2018] [Revised: 11/12/2018] [Accepted: 12/10/2018] [Indexed: 12/20/2022]
Abstract
Much of the existing research on biological mechanisms underlying the stress experience has focused largely on moment-to-moment stress, rather than on chronic stress, an arguably more powerful predictor of long-term outcomes. Recent methodological innovations have paved the way for new lines of research on chronic stress, with promising implications for developmental researchers and for those who study health and adversity. In particular, there are increasing studies that have focused on chronic stress assessments by relying on cortisol derived from hair and nails as a biomarker for chronic stress. In this paper, we provide an overview of their use, describe how hair and nail cortisol ought to be conceptualized differently across the lifespan, how developmental factors may impact its interpretation, and the circumstances under which its use may be more methodologically sensible. The purpose of this review is to provoke further discussion and encourage careful research designs that utilize hair and nail cortisol for understanding the effects of chronic stress exposure from the early developmental period, across adverse contexts, and in association with psychological and physical health outcomes.
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Affiliation(s)
- Cindy H Liu
- Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - Stacey N Doan
- Department of Psychology, Claremont McKenna College, Claremont, CA
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11
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Abstract
In the current study, we present data investigating the relationships among stress, sleep disturbance, self-control, and levels of cortisol (CORT) and dehydroepiandrosterone (DHEA) in fingernail clippings. Currently, hair CORT is the only routinely used noninvasive, validated, biomarker of chronic exposure to stress-related hormones. Nail clippings represent an important potential alternative sample matrix for assessing chronic hormone exposure, as it offers a different timeline of hormone incorporation than scalp hair, and may be obtainable from populations in which hair either is lacking or is unavailable for cultural reasons. Moreover, there is established precedent for using fingernail clippings to attain biomarker data. However, the value of nail hormone assessment for psychological research is currently unknown due to a paucity of information on the relations between nail hormone concentrations and environmental or psychological variables. In the present study, we collected data from a low income, minority population (N = 47; 97% African American) to demonstrate feasibility and acceptability of nail collection and analysis of the adrenal steroids CORT and DHEA. Participants reported on perceived stress, sleep and self-control abilities. Correlational analyses suggest that exposure to stressful events, disturbances in sleep and waking were associated with higher levels of nail DHEA, while self-control was associated with higher levels of nail CORT. We discuss the potential importance of this methodology for investigating biological, behavioral, and subjective indices of stress and well-being.
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Affiliation(s)
- Stacey N Doan
- a Department of Psychology , Claremont McKenna College , Claremont , CA , USA
| | - Gerrit DeYoung
- b School of Education , Boston University , Boston , MA , USA
| | | | - Cindy Liu
- d BIDMC-Mass. Mental Health Center , Boston , MA , USA
| | - Jerrold Meyer
- e Department of Psychology and Neuroscience, University of Massachusetts , Amherst , MA , USA
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