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Qi M, Gai R, Gao H. The effect of chronic academic stress on intentional forgetting. Q J Exp Psychol (Hove) 2024; 77:433-445. [PMID: 37042464 DOI: 10.1177/17470218231171481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/13/2023]
Abstract
This study investigated whether chronic academic stress could affect the directed forgetting (DF) process. Both the stress group (undergoing preparation for a major academic examination) and the control group performed a DF task. A forgetting cue was presented after a to-be-forgotten (TBF) word, whereas no cue appeared after a to-be-remembered (TBR) item in the study phase. An old/new recognition test was used in the test phase. The results showed that (1) the stress group showed a higher level of self-reported stress, state anxiety, negative affect, and decreased cortisol awakening response (CAR) compared with the control group, suggesting a higher level of stress for the stress group. (2) Both groups showed superior recognition performance of TBR than TBF items, suggesting a DF effect. (3) The stress group showed inferior recognition performance of TBF items and an enhanced DF effect compared with the control group. These results demonstrated that the intentional memory control process might be enhanced under chronic academic stress.
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Affiliation(s)
- Mingming Qi
- School of Psychology, Liaoning Normal University, Dalian, China
| | - Ru Gai
- School of Psychology, Liaoning Normal University, Dalian, China
| | - Heming Gao
- School of Psychology, Liaoning Normal University, Dalian, China
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2
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Peter HL, Giglberger M, Streit F, Frank J, Kreuzpointner L, Rietschel M, Kudielka BM, Wüst S. Association of polygenic scores for depression and neuroticism with perceived stress in daily life during a long-lasting stress period. Genes Brain Behav 2023; 22:e12872. [PMID: 37876358 PMCID: PMC10733580 DOI: 10.1111/gbb.12872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 07/31/2023] [Accepted: 10/06/2023] [Indexed: 10/26/2023]
Abstract
Genetic factors contribute significantly to interindividual differences in the susceptibility to stress-related disorders. As stress can also be conceptualized as environmental exposure, controlled gene-environment interaction (GxE) studies with an in-depth phenotyping may help to unravel mechanisms underlying the interplay between genetic factors and stress. In a prospective-longitudinal quasi-experimental study, we investigated whether polygenic scores (PGS) for depression (DEP-PGS) and neuroticism (NEU-PGS), respectively, were associated with responses to chronic stress in daily life. We examined law students (n = 432) over 13 months. Participants in the stress group experienced a long-lasting stress phase, namely the preparation for the first state examination for law students. The control group consisted of law students without particular stress exposure. In the present manuscript, we analyzed perceived stress levels assessed at high frequency and in an ecologically valid manner by ambulatory assessments as well as depression symptoms and two parameters of the cortisol awakening response. The latter was only assessed in a subsample (n = 196). No associations between the DEP-PGS and stress-related variables were found. However, for the NEU-PGS we found a significant GxE effect. Only in individuals experiencing academic stress a higher PGS for neuroticism predicted stronger increases of perceived stress levels until the exam. At baseline, a higher NEU-PGS was associated with higher perceived stress levels in both groups. Despite the small sample size, we provide preliminary evidence that the genetic disposition for neuroticism is associated with stress level increases in daily life during a long-lasting stress period.
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Affiliation(s)
- Hannah L. Peter
- Institute of PsychologyUniversity of RegensburgRegensburgGermany
| | | | - Fabian Streit
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental HealthUniversity of MannheimMannheimGermany
| | - Josef Frank
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental HealthUniversity of MannheimMannheimGermany
| | | | - Marcella Rietschel
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental HealthUniversity of MannheimMannheimGermany
| | | | - Stefan Wüst
- Institute of PsychologyUniversity of RegensburgRegensburgGermany
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Anderson G. Melatonin, BAG-1 and cortisol circadian interactions in tumor pathogenesis and patterned immune responses. Explor Target Antitumor Ther 2023; 4:962-993. [PMID: 37970210 PMCID: PMC10645470 DOI: 10.37349/etat.2023.00176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2023] [Accepted: 08/07/2023] [Indexed: 11/17/2023] Open
Abstract
A dysregulated circadian rhythm is significantly associated with cancer risk, as is aging. Both aging and circadian dysregulation show suppressed pineal melatonin, which is indicated in many studies to be linked to cancer risk and progression. Another independently investigated aspect of the circadian rhythm is the cortisol awakening response (CAR), which is linked to stress-associated hypothalamus-pituitary-adrenal (HPA) axis activation. CAR and HPA axis activity are primarily mediated via activation of the glucocorticoid receptor (GR), which drives patterned gene expression via binding to the promotors of glucocorticoid response element (GRE)-expressing genes. Recent data shows that the GR can be prevented from nuclear translocation by the B cell lymphoma-2 (Bcl-2)-associated athanogene 1 (BAG-1), which translocates the GR to mitochondria, where it can have diverse effects. Melatonin also suppresses GR nuclear translocation by maintaining the GR in a complex with heat shock protein 90 (Hsp90). Melatonin, directly and/or epigenetically, can upregulate BAG-1, suggesting that the dramatic 10-fold decrease in pineal melatonin from adolescence to the ninth decade of life will attenuate the capacity of night-time melatonin to modulate the effects of the early morning CAR. The interactions of pineal melatonin/BAG-1/Hsp90 with the CAR are proposed to underpin how aging and circadian dysregulation are associated with cancer risk. This may be mediated via differential effects of melatonin/BAG-1/Hsp90/GR in different cells of microenvironments across the body, from which tumors emerge. This provides a model of cancer pathogenesis that better integrates previously disparate bodies of data, including how immune cells are regulated by cancer cells in the tumor microenvironment, at least partly via the cancer cell regulation of the tryptophan-melatonin pathway. This has a number of future research and treatment implications.
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Vulpius GM, Köhler-Forsberg K, Ozenne B, Larsen SV, Nasser A, Svarer C, Gillings N, Keller SH, Jørgensen MB, Knudsen GM, Frokjaer VG. Stress Hormone Dynamics Are Coupled to Brain Serotonin 4 Receptor Availability in Unmedicated Patients With Major Depressive Disorder: A NeuroPharm Study. Int J Neuropsychopharmacol 2023; 26:639-648. [PMID: 37542733 PMCID: PMC10519814 DOI: 10.1093/ijnp/pyad041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 08/03/2023] [Indexed: 08/07/2023] Open
Abstract
BACKGROUND A prominent finding in major depressive disorder (MDD) is distorted stress hormone dynamics, which is regulated by serotonergic brain signaling. An interesting feature of the cerebral serotonin system is the serotonin 4 receptor (5-HT4R), which is lower in depressed relative to healthy individuals and also has been highlighted as a promising novel antidepressant target. Here, we test the novel hypothesis that brain 5-HT4R availability in untreated patients with MDD is correlated with cortisol dynamics, indexed by the cortisol awakening response (CAR). Further, we evaluate if CAR changes with antidepressant treatment, including a selective serotonin reuptake inhibitor, and if pretreatment CAR can predict treatment outcome. METHODS Sixty-six patients (76% women) with a moderate to severe depressive episode underwent positron emission tomography imaging with [11C]SB207145 for quantification of brain 5-HT4R binding using BPND as outcome. Serial home sampling of saliva in the first hour from awakening was performed to assess CAR before and after 8 weeks of antidepressant treatment. Treatment outcome was measured by change in Hamilton Depression Rating Scale 6 items. RESULTS In the unmedicated depressed state, prefrontal and anterior cingulate cortices 5-HT4R binding was positively associated with CAR. CAR remained unaltered after 8 weeks of antidepressant treatment, and pretreatment CAR did not significantly predict treatment outcome. CONCLUSIONS Our findings highlight a link between serotonergic disturbances in MDD and cortisol dynamics, which likely is involved in disease and treatment mechanisms. Further, our data support 5-HT4R agonism as a promising precision target in patients with MDD and disturbed stress hormone dynamics.
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Affiliation(s)
- Gunild M Vulpius
- Neurobiology Research Unit, Copenhagen University Hospital Rigshospitalet, Denmark
- Psychiatric Center Copenhagen, Denmark
| | - Kristin Köhler-Forsberg
- Neurobiology Research Unit, Copenhagen University Hospital Rigshospitalet, Denmark
- Psychiatric Center Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Denmark
| | - Brice Ozenne
- Neurobiology Research Unit, Copenhagen University Hospital Rigshospitalet, Denmark
- Department of Public Health, Section of Biostatistics, University of Copenhagen, Denmark
| | - Søren V Larsen
- Neurobiology Research Unit, Copenhagen University Hospital Rigshospitalet, Denmark
- Department of Clinical Medicine, University of Copenhagen, Denmark
| | - Arafat Nasser
- Neurobiology Research Unit, Copenhagen University Hospital Rigshospitalet, Denmark
| | - Claus Svarer
- Neurobiology Research Unit, Copenhagen University Hospital Rigshospitalet, Denmark
| | - Nic Gillings
- Department of Clinical Physiology and Nuclear Medicine, Copenhagen University Hospital Rigshospitalet, Denmark
| | - Sune H Keller
- Department of Clinical Physiology and Nuclear Medicine, Copenhagen University Hospital Rigshospitalet, Denmark
| | - Martin B Jørgensen
- Neurobiology Research Unit, Copenhagen University Hospital Rigshospitalet, Denmark
- Psychiatric Center Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Denmark
| | - Gitte M Knudsen
- Neurobiology Research Unit, Copenhagen University Hospital Rigshospitalet, Denmark
- Department of Clinical Medicine, University of Copenhagen, Denmark
| | - Vibe G Frokjaer
- Neurobiology Research Unit, Copenhagen University Hospital Rigshospitalet, Denmark
- Psychiatric Center Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Denmark
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Schmidt LI, Neubauer AB, Stoffel M, Ditzen B, Schirmaier J, Farrenkopf C, Sieverding M. Effects of mental contrasting on sleep and associations with stress: A randomized controlled trial. J Health Psychol 2023; 28:1057-1071. [PMID: 36922707 PMCID: PMC10492430 DOI: 10.1177/13591053231159168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/18/2023] Open
Abstract
Mental contrasting with implementation intentions (MCII) has been successfully applied to improve health-related behaviors (e.g. exercise). We explored its effectiveness to improve sleep outcomes beyond effects of sleep hygiene (SH) information, and investigated associations with stress. Eighty university employees (mean age: 29.6, SD = 4.5) were randomized to either a MCII + SH or a SH-only condition. During a baseline-week and a post-intervention week, sleep duration (Fitbit Alta and self-report), sleep quality, and stress were assessed daily and saliva was collected to assess the cortisol awakening response (CAR). In total, self-reported sleep quality and duration increased, but there was no meaningful condition*week interaction for sleep parameters or CAR. Higher average stress was associated with shorter sleep duration and lower sleep quality. Within-person, days with higher stress were followed by nights with lower sleep quality. Despite overall improvements, effects of MCII were not confirmed. MCII might be less effective to improve behaviors which are less controllable.
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Affiliation(s)
| | - Andreas B Neubauer
- DIPF | Leibniz Institute for Research and Information in Education, Germany
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Romney CE, Arroyo AC, Robles TF, Zawadzki MJ. Hugs and Cortisol Awakening Response the Next Day: An Ecological Momentary Assessment Study. Int J Environ Res Public Health 2023; 20:5340. [PMID: 37047955 PMCID: PMC10094596 DOI: 10.3390/ijerph20075340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 03/14/2023] [Accepted: 03/16/2023] [Indexed: 06/19/2023]
Abstract
Previous research suggests that affectionate touch such as hugs might downregulate stress systems such as the hypothalamic pituitary adrenal (HPA) axis. However, the current literature lacks in generalizability beyond the laboratory setting and outside the context of romantic relationships. The cortisol awakening response (CAR) is a measure of the HPA axis and is responsive to daily fluctuations in stress and social information. However, associations between affectionate touch and the CAR have never been assessed. This study used ecological momentary assessment (EMA) to measure daily hugging behaviors in 104 first-year college students and salivary cortisol to assess the CAR. Participants who reported more daily hugs in their social interactions had significantly smaller CARs the next morning compared to days they reported fewer hugs. This study contributes to the literature on social interactions and stress responsive systems and emphasizes the importance of assessing affectionate touch behaviors such as hugs that can be exchanged outside the context of romantic relationships.
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Affiliation(s)
- Chelsea E. Romney
- Department of Psychology, Brigham Young University, Provo, UT 84602, USA
| | - Amber Carmen Arroyo
- Department of Psychological Sciences, University of California Merced, Merced, CA 95343, USA
| | - Theodore F. Robles
- Department of Psychology, University of California Los Angeles, Los Angeles, CA 90095, USA
| | - Matthew J. Zawadzki
- Department of Psychological Sciences, University of California Merced, Merced, CA 95343, USA
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7
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Elder GJ, Altena E, Palagini L, Ellis JG. Stress and the hypothalamic-pituitary-adrenal axis: How can the COVID-19 pandemic inform our understanding and treatment of acute insomnia? J Sleep Res 2023:e13842. [PMID: 36748346 DOI: 10.1111/jsr.13842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 01/09/2023] [Accepted: 01/16/2023] [Indexed: 02/08/2023]
Abstract
Stress and sleep are very closely linked, and stressful life events can trigger acute insomnia. The ongoing COVID-19 pandemic is highly likely to represent one such stressful life event. Indeed, a wide range of cross-sectional studies demonstrate that the pandemic is associated with poor sleep and sleep disturbances. Given the high economic and health burden of insomnia disorder, strategies that can prevent and treat acute insomnia, and also prevent the transition from acute insomnia to insomnia disorder, are necessary. This narrative review outlines why the COVID-19 pandemic is a stressful life event, and why activation of the hypothalamic-pituitary-adrenal axis, as a biological marker of psychological stress, is likely to result in acute insomnia. Further, this review outlines how sleep disturbances might arise as a result of the COVID-19 pandemic, and why simultaneous hypothalamic-pituitary-adrenal axis measurement can inform the pathogenesis of acute insomnia. In particular, we focus on the cortisol awakening response as a marker of hypothalamic-pituitary-adrenal axis function, as cortisol is the end-product of the hypothalamic-pituitary-adrenal axis. From a research perspective, future opportunities include identifying individuals, or particular occupational or societal groups (e.g. frontline health staff), who are at high risk of developing acute insomnia, and intervening. From an acute insomnia treatment perspective, priorities include testing large-scale online behavioural interventions; examining if reducing the impact of stress is effective and, finally, assessing whether "sleep vaccination" can maintain good sleep health by preventing the occurrence of acute insomnia, by preventing the transition from acute insomnia to insomnia disorder.
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Affiliation(s)
- Greg J Elder
- Northumbria Sleep Research, Northumbria University, Newcastle upon Tyne, UK
| | - Ellemarije Altena
- Institut de Neurosciences Cognitives et Intégratives d'Aquitaine-UMR 5287 CNRS, Team Neuroimaging and Human Cognition, Université de Bordeaux, Bordeaux, France
| | - Laura Palagini
- Department of Neuroscience and Rehabilitation, Psychiatric Section University of Ferrara, Ferrara, Italy.,Department of Clinical and Experimental Medicine, Psychiatric Section, University of Pisa, Azienda Ospedaliera Universitaria Pisana (AOUP), Pisa, Italy
| | - Jason G Ellis
- Northumbria Sleep Research, Northumbria University, Newcastle upon Tyne, UK
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Rode J, Edebol Carlman HMT, König J, Hutchinson AN, Thunberg P, Persson J, Brummer RJ. Multi-Strain Probiotic Mixture Affects Brain Morphology and Resting State Brain Function in Healthy Subjects: An RCT. Cells 2022; 11:cells11182922. [PMID: 36139496 PMCID: PMC9496704 DOI: 10.3390/cells11182922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2022] [Revised: 09/12/2022] [Accepted: 09/14/2022] [Indexed: 11/16/2022] Open
Abstract
Probiotics can alter brain function via the gut–brain axis. We investigated the effect of a probiotic mixture containing Bifidobacterium longum, Lactobacillus helveticus and Lactiplantibacillus plantarum. In a randomized, placebo-controlled, double-blinded crossover design, 22 healthy subjects (6 m/16 f; 24.2 ± 3.4 years) underwent four-week intervention periods with probiotics and placebo, separated by a four-week washout period. Voxel-based morphometry indicated that the probiotic intervention affected the gray matter volume of a cluster covering the left supramarginal gyrus and superior parietal lobule (p < 0.0001), two regions that were also among those with an altered resting state functional connectivity. Probiotic intervention resulted in significant (FDR < 0.05) functional connectivity changes between regions within the default mode, salience, frontoparietal as well as the language network and several regions located outside these networks. Psychological symptoms trended towards improvement after probiotic intervention, i.e., the total score of the Hospital Anxiety and Depression Scale (p = 0.056) and its depression sub-score (p = 0.093), as well as sleep patterns (p = 0.058). The probiotic intervention evoked distinct changes in brain morphology and resting state brain function alongside slight improvements of psycho(bio)logical markers of the gut–brain axis. The combination of those parameters may provide new insights into the modes of action by which gut microbiota can affect gut–brain communication and hence brain function.
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Affiliation(s)
- Julia Rode
- Nutrition-Gut-Brain Interactions Research Centre, Faculty of Medicine and Health, School of Medical Sciences, Örebro University, 70182 Örebro, Sweden
- Correspondence:
| | - Hanna M. T. Edebol Carlman
- Nutrition-Gut-Brain Interactions Research Centre, Faculty of Medicine and Health, School of Medical Sciences, Örebro University, 70182 Örebro, Sweden
| | - Julia König
- Nutrition-Gut-Brain Interactions Research Centre, Faculty of Medicine and Health, School of Medical Sciences, Örebro University, 70182 Örebro, Sweden
| | - Ashley N. Hutchinson
- Nutrition-Gut-Brain Interactions Research Centre, Faculty of Medicine and Health, School of Medical Sciences, Örebro University, 70182 Örebro, Sweden
| | - Per Thunberg
- Department of Radiology and Medical Physics, Faculty of Medicine and Health, Örebro University, 70182 Örebro, Sweden
| | - Jonas Persson
- Center for Lifespan Developmental Research (LEADER), Faculty of Humanities and Social Sciences, School of Law, Psychology and Social Work, Örebro University, 70182 Örebro, Sweden
| | - Robert J. Brummer
- Nutrition-Gut-Brain Interactions Research Centre, Faculty of Medicine and Health, School of Medical Sciences, Örebro University, 70182 Örebro, Sweden
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Krempel R, Schleicher D, Jarvers I, Ecker A, Brunner R, Kandsperger S. Sleep quality and neurohormonal and psychophysiological accompanying factors in adolescents with depressive disorders: study protocol. BJPsych Open 2022; 8:e57. [PMID: 35236539 PMCID: PMC8935910 DOI: 10.1192/bjo.2022.29] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Depressive disorders are common mental health problems during adolescence. Many adolescents with depression describe difficulties with sleeping. Findings of previous studies regarding changes in objective sleep quality in adolescents with depressive disorders are heterogeneous. AIMS This study aims to investigate differences in objective and subjective sleep quality between adolescents with depressive disorders and healthy peers, and to evaluate if potential changes in sleep occur concurrently with changes in the release of cortisol and alpha-amylase after awakening. METHOD This non-interventional parallel study examines correlations between depressive disorders, sleep quality and release of stress hormones. Sleep quality in the past 2 weeks, severity of depressive symptoms, psychiatric comorbidities and stress response of 30 adolescents with depressive disorders and 30 healthy controls (N = 60) are assessed via questionnaires. In participants' home environments, the objective sleep quality of seven consecutive nights is measured by sleep accelerometry. After awakening, participants answer sleep questionnaires to examine the subjective sleep quality of those nights. Furthermore, salivary cortisol and alpha-amylase are measured three times after awakening (+0 min, +30 min and +45 min after awakening). CONCLUSIONS Sleep is an important factor for prognosis and well-being in adolescents with depression. The results of this study can be highly valuable to integrate a more detailed examination of sleep quality and sleeping impairments in the treatment of adolescent depressive disorders.
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Affiliation(s)
- Rebekka Krempel
- Clinic of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University of Regensburg, Germany
| | - Daniel Schleicher
- Clinic of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University of Regensburg, Germany
| | - Irina Jarvers
- Clinic of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University of Regensburg, Germany
| | - Angelika Ecker
- Clinic of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University of Regensburg, Germany
| | - Romuald Brunner
- Clinic of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University of Regensburg, Germany
| | - Stephanie Kandsperger
- Clinic of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University of Regensburg, Germany
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Ozgocer T, Ucar C, Yildiz S. Daily cortisol awakening response and menstrual symptoms in young females. Stress Health 2022; 38:57-68. [PMID: 34137165 DOI: 10.1002/smi.3074] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 05/21/2021] [Accepted: 06/11/2021] [Indexed: 11/09/2022]
Abstract
Menstrual symptoms include some rhythmical changes and stress perception but women differ in duration and severity of these symptoms. It is not known whether these differences are associated with cortisol awakening response (CAR). The aim of the current study was to follow young women daily for the CAR and menstrual parameters throughout the whole menstrual cycle. Healthy and regularly cycling young women (n = 16, 17 to 31-year-old) participated in the current study. The daily records of severity of problems (DRSP) was filled in daily by the participants. CAR was also assessed daily form the salivary samples collected at a 0-, 15-, 30- and 60-min post-awakening. In terms of daily awakening cortisol profiles, women had either 2-20 (n = 3), or 20-200 (n = 8) or 200-2000 (n = 5) ng/ml cortisol according to the median levels throughout their cycle. CAR was weakly and negatively correlated with DRSP scores but strongly and positively with oestradiol (R2 = 0.300; p = 0.000) and progesterone (R2 = 0.490; p = 0.000) concentrations. Individuals with higher oestradiol and progesterone concentrations did not have high DRSP scores. In conclusion, CAR had a very high between-subject difference but had a low within-subject difference throughout the days of menstrual cycle, suggesting that CAR is a relatively stable personal trait. Moreover, the interplay between cortisol, progesterone and oestradiol appears to be important for the severity of menstrual symptoms.
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Affiliation(s)
- Tuba Ozgocer
- Department of Physiology, Faculty of Medicine, University of Harran, Şanlıurfa, Turkey
| | - Cihat Ucar
- Department of Physiology, Faculty of Medicine, University of Adıyaman, Adıyaman, Turkey
| | - Sedat Yildiz
- Department of Physiology, Faculty of Medicine, University of Inonu, Malatya, Turkey
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Shi X, Nie X, Wu J. The cortisol awakening response and the late positive potentials evoked by unpleasant emotional pictures in healthy adults. Stress 2022; 25:40-47. [PMID: 34882046 DOI: 10.1080/10253890.2021.2008902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
The cortisol awakening response (CAR) refers to a sharp rise in cortisol concentrations within the 45 min following morning awakening. Alterations in CAR have been associated with various internalizing symptoms and brain function. The current study aimed to investigate the association between CAR and neural activity in response to unpleasant emotional pictures. A total of 46 healthy adults (22.55 years ± 1.69) collected saliva samples at 0, 30, and 45 min post-awakening on two days to assess the CAR. In the afternoon after CAR measurement on the first day, electroencephalograms were recorded when the participants completed a passive viewing task. The results showed that a greater CAR was associated with a decreased late positive potential difference score between unpleasant and neutral stimuli. This finding indicates that a larger CAR may be associated with decreased attentional engagement to unpleasant emotional information in healthy adults.
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Affiliation(s)
- Xia Shi
- Department of Psychology, Tianjin University of Technology and Education, Tianjin, China
| | - Xin Nie
- Department of Psychology, Tianjin University of Technology and Education, Tianjin, China
| | - Jianhui Wu
- Center for Brain Disorder and Cognitive Sciences, Shenzhen University, Shenzhen, Guangdong, China
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Cascino G, Monteleone AM, Marciello F, Pellegrino F, Ruzzi V, Monteleone P. Alexithymia and cortisol awakening response in people with eating disorders. World J Biol Psychiatry 2021; 22:546-551. [PMID: 33135561 DOI: 10.1080/15622975.2020.1844291] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVES Alexithymia, which is the inability to recognise and describe one's own emotions, is a transdiagnostic feature across eating disorders (EDs) and it has been associated with prolonged stress exposure. Therefore, we evaluated whether alexithymia was associated with hypothalamus-pituitary-adrenal (HPA) axis functioning, the main endogenous stress response system, in patients with anorexia nervosa (AN) or bulimia nervosa (BN). METHODS 26 women with AN and 26 with BN participated in the study. Alexithymia was evaluated by the Toronto Alexithymia Scale-20 and eating-related psychopathology was measured by the Eating Disorder Inventory-2. The activity of the HPA axis was assessed by measuring the salivary cortisol awakening response (CAR). RESULTS The prevalence of alexithymia did not differ significantly between the two diagnostic groups. Alexithymia was associated with more severe eating-related psychopathology in AN women but not in BN women. A significant reduction in the magnitude of CAR occurred in alexithymic patients with BN compared to non-alexithymic patients, but not in alexithymic women with AN. CONCLUSIONS These results confirm the presence of a more severe specific psychopathology in alexithymic individuals with AN and show, for the first time, an association between alexithymia and a dampened basal activity of the HPA axis in BN.
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Affiliation(s)
- Giammarco Cascino
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", Section of Neurosciences, University of Salerno, Salerno, Italy
| | | | - Francesca Marciello
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", Section of Neurosciences, University of Salerno, Salerno, Italy
| | - Francesca Pellegrino
- Department of Psychiatry, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Valeria Ruzzi
- Department of Psychiatry, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Palmiero Monteleone
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", Section of Neurosciences, University of Salerno, Salerno, Italy
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Smyth N, Milani M, Thorn L, Flynn M, Golding JF, Evans P, Clow A. Smaller Cortisol Awakening Responses Are Associated with Greater Visual Dependence in Postural Control. Healthcare (Basel) 2021; 9:healthcare9060723. [PMID: 34204685 PMCID: PMC8231619 DOI: 10.3390/healthcare9060723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Revised: 05/23/2021] [Accepted: 06/09/2021] [Indexed: 11/16/2022] Open
Abstract
There are known links between the hypothalamic–pituitary–adrenal (HPA) axis and systems responsible for regulating posture. Our aim was to explore directly, for the first time, whether an aspect of circadian HPA axis activity (the cortisol awakening response: CAR) was associated with greater visual dependency in postural control. For measurement of the CAR, electronically monitored saliva samples were collected by participants following morning awakening in their home environment. On the afternoons of the same days, postural sway was measured in the laboratory by exposing participants to static (control) and moving visual stimuli whilst standing still and upright on a force platform. Visual dependence was assessed as the increase in postural sway (path length) during exposure to the moving compared with the static condition. The 44 measurement days were derived from four days for each of eleven healthy participants (mean ± SD age: 51.18 ± 3.3 years). As expected, postural sway was greater when exposed to moving versus static cues. Mixed regression modelling showed that participants with smaller four day average CARs had greater deterioration in postural sway when presented with moving stimuli. These data are the first to document associations between the CAR and visual dependency in postural sway.
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14
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Reid BM, DePasquale CE, Donzella B, Leneman KB, Taylor H, Gunnar MR. Pubertal transition with current life stress and support alters longitudinal diurnal cortisol patterns in adolescents exposed to early life adversity. Dev Psychobiol 2021; 63:e22146. [PMID: 34053063 DOI: 10.1002/dev.22146] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Revised: 04/23/2021] [Accepted: 05/14/2021] [Indexed: 11/05/2022]
Abstract
Current and early life stress (ELS) are associated with diurnal cortisol patterns, which themselves are associated with mental and physical health. The pubertal recalibration hypothesis suggests that the social environment can impact dysregulated cortisol patterns for previously ELS-exposed youth as they transition through puberty. This study examined longitudinal change in cortisol awakening response (CAR) and diurnal slope (DS) across puberty as a function of ELS in infancy, current stress, and social support (N = 290, 7-17 years). The CAR and DS were examined thrice annually with an accelerated longitudinal design with nurse-assessed puberty to assess associations between diurnal cortisol and pubertal recalibration with ELS and the current social environment. Exposure to ELS was associated with less steep DS but not changes in CAR, and no evidence of pubertal calibration was found. The DS became less steep for youth in later pubertal stages and as youth progressed through puberty. The CAR was steeper for youth in later pubertal stages. Across the cohort, current life stress and support were associated with changes in the DS and the CAR through the pubertal transition. The pubertal stage and the peripubertal and pubertal social environment may have important implications for adrenocortical functioning with or without exposure to ELS.
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Affiliation(s)
- Brie M Reid
- Institute of Child Development, University of Minnesota-Twin Cities, Minnesota, Minneapolis, USA
| | - Carrie E DePasquale
- Institute of Child Development, University of Minnesota-Twin Cities, Minnesota, Minneapolis, USA
| | - Bonny Donzella
- Institute of Child Development, University of Minnesota-Twin Cities, Minnesota, Minneapolis, USA
| | - Keira B Leneman
- Institute of Child Development, University of Minnesota-Twin Cities, Minnesota, Minneapolis, USA
| | - Heather Taylor
- Institute of Child Development, University of Minnesota-Twin Cities, Minnesota, Minneapolis, USA
| | - Megan R Gunnar
- Institute of Child Development, University of Minnesota-Twin Cities, Minnesota, Minneapolis, USA
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15
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Smith MG, Ögren M, Thorsson P, Hussain-Alkhateeb L, Pedersen E, Forssén J, Ageborg Morsing J, Persson Waye K. A laboratory study on the effects of wind turbine noise on sleep: results of the polysomnographic WiTNES study. Sleep 2021; 43:5811422. [PMID: 32211778 PMCID: PMC7487868 DOI: 10.1093/sleep/zsaa046] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Revised: 03/16/2020] [Indexed: 11/13/2022] Open
Abstract
STUDY OBJECTIVES Assess the physiologic and self-reported effects of wind turbine noise (WTN) on sleep. METHODS Laboratory sleep study (n = 50 participants: n = 24 living close to wind turbines and n = 26 as a reference group) using polysomnography, electrocardiography, salivary cortisol, and questionnaire endpoints. Three consecutive nights (23:00-07:00): one habituation followed by a randomized quiet Control and an intervention night with synthesized 32 dB LAEq WTN. Noise in WTN nights simulated closed and ajar windows and low and high amplitude modulation depth. RESULTS There was a longer rapid eye movement (REM) sleep latency (+16.8 min) and lower amount of REM sleep (-11.1 min, -2.2%) in WTN nights. Other measures of objective sleep did not differ significantly between nights, including key indicators of sleep disturbance (sleep efficiency: Control 86.6%, WTN 84.2%; wakefulness after sleep onset: Control 45.2 min, WTN 52.3 min; awakenings: Control n = 11.4, WTN n = 11.5) or the cortisol awakening response. Self-reported sleep was consistently rated as worse following WTN nights, and individuals living close to wind turbines had worse self-reported sleep in both the Control and WTN nights than the reference group. CONCLUSIONS Amplitude-modulated continuous WTN may impact on self-assessed and some aspects of physiologic sleep. Future studies are needed to generalize these findings outside of the laboratory and should include more exposure nights and further examine possible habituation or sensitization.
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Affiliation(s)
- Michael G Smith
- Department of Occupational and Environmental Medicine, School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Unit for Experimental Psychiatry, Division of Sleep and Chronobiology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA
| | - Mikael Ögren
- Department of Occupational and Environmental Medicine, School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Pontus Thorsson
- Division of Applied Acoustics, Department of Civil and Environmental Engineering, Chalmers University of Technology, Gothenburg, Sweden.,Akustikverkstan AB, Lidköping, Sweden
| | - Laith Hussain-Alkhateeb
- Department of Occupational and Environmental Medicine, School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Eja Pedersen
- Department of Architecture and the Built Environment, Lund University, Lund, Sweden
| | - Jens Forssén
- Division of Applied Acoustics, Department of Civil and Environmental Engineering, Chalmers University of Technology, Gothenburg, Sweden
| | - Julia Ageborg Morsing
- Department of Occupational and Environmental Medicine, School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Kerstin Persson Waye
- Department of Occupational and Environmental Medicine, School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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16
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Abstract
Teacher stress and burnout contribute to attrition and stress-related health concerns. Despite some positive effects, previous mindfulness-based interventions (MBI) have failed to incorporate key elements of methodological rigor and have included large dosages despite research suggesting that such dosages are iatrogenic. The current study demonstrates the efficacy of a brief MBI (bMBI; four sessions, six total hours) to reduce self-reported stress, burnout, and depression, and suggests the bMBI can protect against deleterious impacts to physiological functioning. The study informs the design and implementation of future MBIs, including strategies for reducing intervention dosages, in order to improve effectiveness and maximize cost-effectiveness.
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Affiliation(s)
- Stephen G. Taylor
- University of South Carolina, Columbia, SC, USA, Department of Psychology
| | - Alex M. Roberts
- University of South Carolina, Columbia, SC, USA, Department of Psychology
| | - Nicole Zarrett
- University of South Carolina, Columbia, SC, USA, Department of Psychology
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17
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Høgsted ES, Borgsted C, Dam VH, Nasser A, Rye Jørgensen N, Ozenne B, Stenbæk DS, Frokjaer VG. Stress-Hormone Dynamics and Working Memory in Healthy Women Who Use Oral Contraceptives Versus Non-Users. Front Endocrinol (Lausanne) 2021; 12:731994. [PMID: 34819917 PMCID: PMC8606688 DOI: 10.3389/fendo.2021.731994] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Accepted: 09/30/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Women who use oral contraceptives (OCs) may have a higher risk of developing a depression, which is associated with both vulnerability to stress and cognitive dysfunction. OCs disrupt the hypothalamic-pituitary-gonadal (HPG) axis by suppressing endogenous sex steroid production including estradiol. The HPG axis and the hypothalamic-pituitary-adrenal (HPA) axis are known to interact, possibly through modulations driven by estradiol. OCs may affect HPA regulation capacity, i.e., disturb cortisol dynamics such as the cortisol awakening response (CAR), and influence cognition such as working memory (WM). We hypothesize that OC use is associated with blunted cortisol dynamics and impaired WM performance relative to non-users. METHODS Data from 78 healthy women in the reproductive age were available from the CIMBI database. We evaluated if CAR and WM differed between OC users (n=25) and non-users (n=53) and if the level of estradiol modulated the OC use effect on CAR or WM in generalized least square models. RESULTS We found that OC users had a blunted CAR (p= 0.006) corresponding to a 61% reduction relative to non-users; however, no estradiol-BY-OC use interaction effect was observed on CAR. Also, OC users had higher cortisol levels at awakening compared to non-users (p = 0.03). We observed no effect of OC use or an estradiol-BY-OC use interaction effect on WM. Also, within the OC user group, neither CAR nor WM was associated with suppressed estradiol. CAR was not associated with WM. CONCLUSION Healthy women who use OCs have blunted cortisol dynamics relative to non-users. However, we could not detect OC use effects on working memory in our sample size. We speculate that disrupted cortisol dynamics may be important for the emergence of depressive symptoms in OC users.
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Affiliation(s)
- Emma Sofie Høgsted
- Neurobiology Research Unit, Copenhagen University Hospital–Rigshospitalet, Copenhagen, Denmark
| | - Camilla Borgsted
- Neurobiology Research Unit, Copenhagen University Hospital–Rigshospitalet, Copenhagen, Denmark
- Mental Health Services, Capital Region of Denmark, Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Vibeke H. Dam
- Neurobiology Research Unit, Copenhagen University Hospital–Rigshospitalet, Copenhagen, Denmark
| | - Arafat Nasser
- Neurobiology Research Unit, Copenhagen University Hospital–Rigshospitalet, Copenhagen, Denmark
| | - Niklas Rye Jørgensen
- Department of Clinical Biochemistry Centre of Diagnostic Investigations, Copenhagen University Hospital–Rigshospitalet, Copenhagen, Denmark
| | - Brice Ozenne
- Neurobiology Research Unit, Copenhagen University Hospital–Rigshospitalet, Copenhagen, Denmark
- Department of Public Health, Section of Biostatistics, University of Copenhagen, Copenhagen, Denmark
| | - Dea Siggaard Stenbæk
- Neurobiology Research Unit, Copenhagen University Hospital–Rigshospitalet, Copenhagen, Denmark
- Department of Psychology, Faculty of Social Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Vibe G. Frokjaer
- Neurobiology Research Unit, Copenhagen University Hospital–Rigshospitalet, Copenhagen, Denmark
- Mental Health Services, Capital Region of Denmark, Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
- Department of Psychology, Faculty of Social Sciences, University of Copenhagen, Copenhagen, Denmark
- *Correspondence: Vibe G. Frokjaer,
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18
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Kuhlman KR, Chiang JJ, Bower JE, Irwin MR, Seeman TE, McCreath HE, Almeida DM, Dahl RE, Fuligni AJ. Sleep problems in adolescence are prospectively linked to later depressive symptoms via the cortisol awakening response. Dev Psychopathol 2020; 32:997-1006. [PMID: 31387652 DOI: 10.1017/S0954579419000762] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Sleep disturbance is a symptom of and a well-known risk factor for depression. Further, atypical functioning of the HPA axis has been linked to the pathogenesis of depression. The purpose of this study was to examine the role of adolescent HPA axis functioning in the link between adolescent sleep problems and later depressive symptoms. Methods: A sample of 157 17-18 year old adolescents (61.8% female) completed the Pittsburgh Sleep Quality Inventory (PSQI) and provided salivary cortisol samples throughout the day for three consecutive days. Two years later, adolescents reported their depressive symptoms via the Center for Epidemiological Studies Depression Scale (CES-D). Results: Individuals (age 17-18) with greater sleep disturbance reported greater depressive symptoms two years later (age 19-20). This association occurred through the indirect effect of sleep disturbance on the cortisol awakening response (CAR) (indirect effect = 0.14, 95%CI [.02 -.39]). Conclusions: One pathway through which sleep problems may lead to depressive symptoms is by up-regulating components of the body's physiological stress response system that can be measured through the cortisol awakening response. Behavioral interventions that target sleep disturbance in adolescents may mitigate this neurobiological pathway to depression during this high-risk developmental phase.
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19
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Kovac K, Ferguson SA, Paterson JL, Aisbett B, Hilditch CJ, Reynolds AC, Vincent GE. Exercising Caution Upon Waking-Can Exercise Reduce Sleep Inertia? Front Physiol 2020; 11:254. [PMID: 32317980 PMCID: PMC7155753 DOI: 10.3389/fphys.2020.00254] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2019] [Accepted: 03/05/2020] [Indexed: 11/13/2022] Open
Abstract
Sleep inertia, the transitional state of reduced alertness and impaired cognitive performance upon waking, is a safety risk for on-call personnel who can be required to perform critical tasks soon after waking. Sleep inertia countermeasures have previously been investigated; however, none have successfully dissipated sleep inertia within the first 15 min following waking. During this time, on-call personnel could already be driving, providing advice, or performing other safety-critical tasks. Exercise has not yet been investigated as a sleep inertia countermeasure but has the potential to stimulate the key physiological mechanisms that occur upon waking, including changes in cerebral blood flow, the cortisol awakening response, and increases in core body temperature. Here, we examine these physiological processes and hypothesize how exercise can stimulate them, positioning exercise as an effective sleep inertia countermeasure. We then propose key considerations for research investigating the efficacy of exercise as a sleep inertia countermeasure, including the need to determine the intensity and duration of exercise required to reduce sleep inertia, as well as testing the effectiveness of exercise across a range of conditions in which the severity of sleep inertia may vary. Finally, practical considerations are identified, including the recommendation that qualitative field-based research be conducted with on-call personnel to determine the potential constraints in utilizing exercise as a sleep inertia countermeasure in real-world scenarios.
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Affiliation(s)
- Katya Kovac
- Appleton Institute, School of Health, Medical and Applied Sciences, Central Queensland University, Adelaide, SA, Australia
| | - Sally A Ferguson
- Appleton Institute, School of Health, Medical and Applied Sciences, Central Queensland University, Adelaide, SA, Australia
| | - Jessica L Paterson
- Appleton Institute, School of Health, Medical and Applied Sciences, Central Queensland University, Adelaide, SA, Australia
| | - Brad Aisbett
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC, Australia
| | - Cassie J Hilditch
- Fatigue Countermeasures Laboratory, San José State University Research Foundation, Moffett Field, CA, United States
| | - Amy C Reynolds
- Appleton Institute, School of Health, Medical and Applied Sciences, Central Queensland University, Adelaide, SA, Australia
| | - Grace E Vincent
- Appleton Institute, School of Health, Medical and Applied Sciences, Central Queensland University, Adelaide, SA, Australia
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20
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Roberts LR, Boostrom GG, Dehom SO, Neece CL. Self-Reported Parenting Stress and Cortisol Awakening Response Following Mindfulness-Based Stress Reduction Intervention for Parents of Children With Developmental Delays: A Pilot Study. Biol Res Nurs 2019; 22:217-225. [PMID: 31755301 DOI: 10.1177/1099800419890125] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND Many parents of children with developmental delays (DDs) experience high levels of parental stress, and young children with DDs are likely to exhibit clinical levels of behavioral problems. The reciprocal relationship between the two issues makes these families vulnerable to stress-related health risks. To address this, the current study aims to investigate the effectiveness of mindfulness-based stress reduction (MBSR) at reducing parent stress, as measured by both psychological self-report and a physiological biomarker. METHOD A pretest-posttest design with a 6-month follow-up assessment was used to establish effectiveness with analyses of within-subject effects. Parents (N = 47) of children (2.5-5 years of age) with DDs participated in a standard 8-week MBSR intervention. Measures included the Parenting Daily Hassles, a self-report measure of perceived frequency and intensity of parenting stress, and salivary samples for measurement of the cortisol awakening response (CAR), a biological marker of stress response. RESULTS Both self-reported parenting stress and CAR decreased following MBSR for parents of children with DDs. The greatest difference in means over time was between baseline and follow-up, where changes in effect size were even stronger for biological markers than for self-report measures. CONCLUSION The MBSR intervention reduced both perceived and physiologic stress. Health-care professionals caring for these families might consider encouraging parents to participate in MBSR as both treatment and prevention of parenting stress.
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21
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Sanchez Hernandez H, Urizar GG, Yim IS. The influence of mindfulness and social support on stress reactivity during pregnancy. Stress Health 2019; 35:330-340. [PMID: 30882972 DOI: 10.1002/smi.2865] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2018] [Revised: 02/18/2019] [Accepted: 03/10/2019] [Indexed: 12/16/2022]
Abstract
Exaggerated stress reactivity can lead to negative health outcomes, which can be especially harmful during important periods of development such as pregnancy. Therefore, studies are needed to examine potential protective factors associated with lower perceived stress reactivity and lower cortisol awakening response (CAR) during pregnancy. The current cross-sectional study examined whether low-income women (n = 152) with higher mindfulness (attentiveness and awareness of the present moment) and more perceived social support had lower levels of perceived stress reactivity and a lower CAR during pregnancy. Women completed self-report measures of mindfulness (Mindful Attention Awareness Scale), social support (Medical Outcomes Study-Social Support Scale), and perceived stress reactivity (Perceived Stress Reactivity Scale) during their first trimester of pregnancy and collected saliva using the passive drool procedure at home (at awakening and at 30 min after awakening). Results showed that women with greater mindfulness and greater perceived social support had significantly lower perceived stress reactivity, but not a lower CAR. These results provide preliminary support for mindfulness and social support as potential protective factors of perceived stress reactivity and have implications for experimental studies aimed at improving pregnant women's mindfulness and social support for reducing their stress reactivity and potentially improving health outcomes.
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Affiliation(s)
| | - Guido G Urizar
- Department of Psychology, California State University, Long Beach, California
| | - Ilona S Yim
- Department of Psychological Science, University of California, Irvine, California
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22
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MacDonald D, Wetherell MA. Competition Stress Leads to a Blunting of the Cortisol Awakening Response in Elite Rowers. Front Psychol 2019; 10:1684. [PMID: 31379693 PMCID: PMC6657667 DOI: 10.3389/fpsyg.2019.01684] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Accepted: 07/03/2019] [Indexed: 11/13/2022] Open
Abstract
Background: Anticipation of forthcoming demands is often met with biological up-regulation, for example, levels of the stress hormone cortisol are typically elevated immediately prior to an anticipated event. Similarly, the cortisol awakening response (CAR), a surge in cortisol in the period following waking, is elevated on days of anticipated demand and this is viewed as an adaptive response in the preparation for challenge. This study assessed the effects of competition as an anticipated challenge in elite rowers. Methods: Elite rowers (N = 8) were assessed during two training and two competition weekends. Each assessment involved the measurement of self-reported competitive (cognitive and somatic) anxiety and salivary diurnal cortisol across 2 days representing a preparation day prior to either a training or competition day. Competitive anxiety was measured each morning and saliva samples were provided immediately upon waking and 30 min post waking (CAR) and before bed. Results: Self-reported cognitive and somatic anxiety levels were significantly greater during the competition phase compared with training. Additionally, levels of cognitive anxiety were greater on the day of competition compared with the preparation day. CAR magnitude was significantly reduced during the competition phase compared with training; however, there were no differences between preparation and event days. Conclusions: Reduced or blunted CARs are typically observed in chronically stressed populations and are characteristic of burnout and fatigue. While an increased CAR during competition may represent an adaptive response to challenge, blunted CARs and the concomitant increases in competitive anxiety observed here indicate maladaptive responding during a period where maximized functioning is critical.
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Affiliation(s)
- Douglas MacDonald
- Psychobiology Research Group, Department of Psychology, Northumbria University, Newcastle upon Tyne, United Kingdom
- Scottish Canoe Association, Edinburgh, United Kingdom
| | - Mark A. Wetherell
- Psychobiology Research Group, Department of Psychology, Northumbria University, Newcastle upon Tyne, United Kingdom
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23
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Weidenauer C, Vollmer C, Scheiter K, Randler C. Weak Associations of Morningness-Eveningness and Stability with Skin Temperature and Cortisol Levels. J Circadian Rhythms 2019; 17:8. [PMID: 31346336 DOI: 10.5334/jcr.182] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
Differences in daytime preferences can be described on the dimension of morningness-eveningness (continuous) or circadian typology (categorical) and are associated with our physiological functioning, which is reflected in body temperature and cortisol levels in the morning. The purpose of the present study was to explore the relationship between morningness-eveningness, stability and physiological markers (body temperature and cortisol) based on a three-dimensional conceptualization of morningness-eveningness using the Morningness-Eveningness-Stability Scale improved (MESSi). In contrast to previously used unidimensional measures, the MESSi determines circadian typology and its amplitude in three dimensions: Morning affect (MA), Eveningness (EV) and Stability/Distinctness (DI). Furthermore, the differences of the cortisol levels between weekday and weekend were examined. The sample (N = 42) consisted of extreme chronotypes (age 18–54 years; M = 24.8 years, SD = 5.83; 22 morning types [5 men and 17 women] and 20 evening types [8 men and 12 women]). The participants were asked to measure their skin temperature for one week and sample four saliva probes for cortisol determination. Morning types showed a better fit in the actual temperature data to the approximating data as compared to Evening types and showed a higher overall temperature. The Stability/Distinctness (DI) component of the MESSi was negatively correlated with the nadir. Morning types also showed higher cortisol levels than Evening types immediately after awakening. The cortisol levels were higher on a weekday compared to the weekend. To conclude, the present findings demonstrate that the skin temperature is weakly associated with morningness-eveningness and the stability of the circadian phase.
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24
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Vrshek-Schallhorn S, Stroud CB, Doane LD, Mineka S, Zinbarg RE, Redei EE, Craske MG, Adam EK. Cortisol awakening response and additive serotonergic genetic risk interactively predict depression in two samples: The 2019 Donald F. Klein Early Career Investigator Award Paper. Depress Anxiety 2019; 36:480-489. [PMID: 31017373 PMCID: PMC8237709 DOI: 10.1002/da.22899] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2018] [Revised: 02/16/2019] [Accepted: 03/22/2019] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND The serotonin system and hypothalamic pituitary-adrenal (HPA)-axis are each implicated in the pathway to depression; human and animal research support these systems' cross-talk. Our work implicates a 5-variant additive serotoninergic multilocus genetic profile score (MGPS) and separately the cortisol awakening response (CAR) in the prospective prediction of depression; other work has shown that the serotonin transporter polymorphism 5HTTLPR predicts CAR and interacts with the CAR to predict depression. METHODS We tested the hypothesis that a 6-variant MGPS (original plus 5HTTLPR) would interact with CAR to predict prospective depressive episode onsets in 201 emerging adults using four annual follow-up interviews. We also tested whether MGPS predicted CAR. We attempted replication of significant findings in a sample of 77 early adolescents predicting depression symptoms. RESULTS In sample 1, MGPS did not significantly predict CAR. MGPS interacted with CAR to predict depressive episodes; CAR slopes for depression steepened as MGPS increased, for risk or protection. No single variant accounted for results, though CAR's interactions with 5HTTLPR and the original MGPS were both significant. In sample 2, the 6-variant MGPS significantly interacted with CAR to predict depression symptoms. CONCLUSIONS Higher serotonergic MGPS appears to sensitize individuals to CAR level-for better and worse-in predicting depression.
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Affiliation(s)
- Suzanne Vrshek-Schallhorn
- Department of Psychology, University of North Carolina at Greensboro,Correspondence concerning this article may be directed to Suzanne Vrshek-Schallhorn, PhD, at the Department of Psychology, University of North Carolina at Greensboro, 296 Eberhart Building, P.O. Box 26170, Greensboro, NC, 27402-6170, Phone: 1-336-256-8538, Fax: 1-336-334-5066,
| | | | | | - Susan Mineka
- Department of Psychology, Northwestern University
| | - Richard E. Zinbarg
- Department of Psychology, Northwestern University,The Family Institute at Northwestern University
| | - Eva E. Redei
- Department of Psychiatry & Behavioral Sciences, Feinberg School of Medicine, Northwestern University
| | | | - Emma K. Adam
- School of Education & Social Policy and Cells to Society Center, Institute for Policy Research, Northwestern University
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25
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Yu R, Branje S, Meeus W, Cowen P, Fazel S. Depression, violence and cortisol awakening response: a 3-year longitudinal study in adolescents. Psychol Med 2019; 49:997-1004. [PMID: 30012227 PMCID: PMC6240346 DOI: 10.1017/s0033291718001654] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2017] [Revised: 04/05/2018] [Accepted: 05/29/2018] [Indexed: 11/28/2022]
Abstract
BACKGROUND Despite evidence of links between depression and violent outcomes, potential moderators of this association remain unknown. The current study tested whether a biological marker, cortisol, moderated this association in a longitudinal sample of adolescents. METHODS Participants were 358 Dutch adolescents (205 boys) with a mean age of 15 years at the first measurement. Depressive symptoms, the cortisol awakening response (CAR) and violent outcomes were measured annually across 3 years. The CAR was assessed by two measures: waking cortisol activity (CAR area under the curve ground) and waking cortisol reactivity (CAR area under the curve increase). Within-individual regression models were adopted to test the interaction effects between depressive symptoms and CAR on violent outcomes, which accounted for all time-invariant factors such as genetic factors and early environments. We additionally adjusted for time-varying factors including alcohol drinking, substance use and stressful life events. RESULTS In this community sample, 24% of adolescents perpetrated violent behaviours over 3 years. We found that CAR moderated the effects of depressive symptoms on adolescent violent outcomes (βs ranged from -0.12 to -0.28). In particular, when the CAR was low, depressive symptoms were positively associated with violent outcomes in within-individual models, whereas the associations were reversed when the CAR was high. CONCLUSIONS Our findings suggest that the CAR should be investigated further as a potential biological marker for violence in adolescents with high levels of depressive symptoms.
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Affiliation(s)
- Rongqin Yu
- Department of Psychiatry, University of Oxford, Oxford, UK
| | - Susan Branje
- Department of Youth and Family, Utrecht University, Utrecht, The Netherlands
| | - Wim Meeus
- Department of Youth and Family, Utrecht University, Utrecht, The Netherlands
- Department of Developmental Psychology, Tilburg University, Tilburg, The Netherlands
| | - Philip Cowen
- Department of Psychiatry, University of Oxford, Oxford, UK
| | - Seena Fazel
- Department of Psychiatry, University of Oxford, Oxford, UK
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Abstract
Breastfeeding is associated with positive maternal and infant outcomes. It is recommended that women exclusively breastfeed for the first 6 months postpartum; however, these recommendations are not met in the majority of women. Psychological distress in pregnancy is associated with lower rates of breastfeeding initiation and duration in the postpartum period. The mechanisms linking maternal distress to breastfeeding are not understood. In this study we examined maternal circadian cortisol as a mechanism linking distress in pregnancy to breastfeeding. This study is a secondary data analysis of 197 pregnant women with singleton pregnancies who were part of a larger study of the effects of maternal mood on fetal and infant development. About 34% of women reported exclusively breastfeeding, 18% reported exclusively formula feeding, and 48% reported mixed feeding. Participants reported on perceived stress, perinatal anxiety and depression, and socioeconomic status during pregnancy. They provided salivary cortisol samples at three times a day for 3 days at 24, 30, and 36 weeks' gestation. Participants who reported lower socioeconomic status in pregnancy were less likely to breastfeed, and lower maternal cortisol awakening responses mediated this association. This area of research may identify foci in the prenatal period that could serve as targets for interventions to increase rates of breastfeeding. Lay summary Pregnant women who reported lower socioeconomic status in pregnancy were less likely to breastfeed. This association was mediated by lower cortisol awakening responses, but not evening cortisol levels, over pregnancy.
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Affiliation(s)
- M H Bublitz
- a The Miriam Hospital , Providence , RI , USA
- b Department of Medicine , Alpert Medical School of Brown University , Providence , RI , USA
- c Department of Psychiatry and Human Behavior , Alpert Medical School of Brown University , Providence , RI , USA
| | - G Bourjeily
- a The Miriam Hospital , Providence , RI , USA
- b Department of Medicine , Alpert Medical School of Brown University , Providence , RI , USA
| | - C Bilodeau
- a The Miriam Hospital , Providence , RI , USA
- b Department of Medicine , Alpert Medical School of Brown University , Providence , RI , USA
| | - L R Stroud
- a The Miriam Hospital , Providence , RI , USA
- c Department of Psychiatry and Human Behavior , Alpert Medical School of Brown University , Providence , RI , USA
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Van Dam JM, Garrett AJ, Schneider LA, Buisman-Pijlman FTA, Short MA, Hodyl NA, Edwards HK, Goldsworthy MR, Pitcher JB. Variability of the cortisol awakening response and morning salivary oxytocin in late adolescence. J Neuroendocrinol 2018; 30:e12645. [PMID: 30216577 DOI: 10.1111/jne.12645] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2018] [Revised: 08/19/2018] [Accepted: 09/10/2018] [Indexed: 11/27/2022]
Abstract
Exogenously administered oxytocin interacts with the hypothalamic-pituitary-adrenal (HPA) axis to modulate endogenous cortisol levels, suggesting a synergistic role for these two hormones in the response to stress, cognitive performance and the development of psycho-behavioural disorders. The cortisol awakening response (CAR) is considered a reliable measure of HPA axis function in humans. However, the CAR appears to vary considerably from day to day and may be strongly influenced by the anticipated demands of the day ahead. The level of variation intrinsic to the CAR is unclear because few studies have examined the CAR in the absence of daily environmental variation. It is not known whether oxytocin has a similar or complementary awakening response. Therefore, over three consecutive days, we examined 12 adolescents (aged 15-17 years) in a highly-controlled sleep laboratory. Saliva was collected on days 4-6 of a 9-day laboratory visit. Cortisol and oxytocin levels were determined by an enzyme-linked immunosorbent assay from saliva sampled at 0, 15, 30 and 45 minutes, and 8 and 12 hours post-awakening. CAR magnitude varied between days and was associated with sleep duration and pre-awakening sleep stage. Conversely, oxytocin levels dropped dramatically in the first 15 minutes post-awakening and were highly consistent across participants and days. Older participants had higher awakening oxytocin concentrations. Although cortisol increases and oxytocin rapidly declines upon awakening, their diurnal variation does not appear to be related at basal, peripheral levels, consistent with a previous finding that exogenously administered oxytocin only modulates cortisol under conditions of stress.
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Affiliation(s)
- Jago M Van Dam
- Adelaide Medical School, Robinson Research Institute, University of Adelaide, Adelaide, SA, Australia
| | - Amy J Garrett
- Adelaide Medical School, Robinson Research Institute, University of Adelaide, Adelaide, SA, Australia
| | - Luke A Schneider
- Adelaide Medical School, Robinson Research Institute, University of Adelaide, Adelaide, SA, Australia
| | - Femke T A Buisman-Pijlman
- Discipline of Pharmacology, Adelaide Medical School, University of Adelaide, Adelaide, SA, Australia
| | - Michelle A Short
- Centre for Sleep Research, University of South Australia, Adelaide, SA, Australia
- School of Psychology, Flinders University, Adelaide, SA, Australia
| | - Nicolette A Hodyl
- Adelaide Medical School, Robinson Research Institute, University of Adelaide, Adelaide, SA, Australia
| | - Hannah K Edwards
- School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, SA, Australia
| | - Mitchell R Goldsworthy
- Adelaide Medical School, Robinson Research Institute, University of Adelaide, Adelaide, SA, Australia
| | - Julia B Pitcher
- Adelaide Medical School, Robinson Research Institute, University of Adelaide, Adelaide, SA, Australia
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Bernsdorf M, Schwabe L. Cortisol response to awakening in prepubertal children and adults: Magnitude and variability. Psychophysiology 2018; 55:e13273. [PMID: 30101985 DOI: 10.1111/psyp.13273] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2018] [Revised: 06/13/2018] [Accepted: 07/04/2018] [Indexed: 12/24/2022]
Abstract
Within the first 30-45 min after awakening, there is a characteristic rise in cortisol that is referred to as cortisol awakening response (CAR). Over the past decades, the CAR has become an important biomarker, mainly because of its reported association with health and disease. Previous research showed that the CAR can already be reliably assessed in infants and children. Yet, earlier findings on the influence of age have been inconsistent, and limited attention has been devoted to prepubertal children. Here, we aimed to contrast the magnitude and stability of the CAR in prepubertal children and adults. To this end, 24 healthy adults between 35 and 50 years of age and 24 healthy children between 6 and 9 years of age collected four salivary cortisol samples within 45 min after awakening on 4 separate days, 2 weekdays, and 2 weekend days. Our results showed that there was a marked CAR on weekdays and weekend days in both adults and children. In children, however, the CAR was overall significantly attenuated relative to adults. Moreover, while the cortisol increases after awakening were, both on weekdays and weekend days, highly correlated in adults, there were no such associations in children. Together, these data suggest that the CAR is less pronounced and less stable in prepubertal children compared to adults. Such age differences need to be taken into account when using the CAR as a biomarker in clinical settings.
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Affiliation(s)
- Manja Bernsdorf
- Department of Cognitive Psychology, Institute of Psychology, University of Hamburg, Hamburg, Germany
| | - Lars Schwabe
- Department of Cognitive Psychology, Institute of Psychology, University of Hamburg, Hamburg, Germany
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Puig-Perez S, Pulopulos MM, Hidalgo V, Salvador A. Being an optimist or a pessimist and its relationship with morning cortisol release and past life review in healthy older people. Psychol Health 2017; 33:783-799. [PMID: 29166781 DOI: 10.1080/08870446.2017.1408807] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVE Investigate the relationship between optimism and pessimism and the cortisol awakening response (CAR) and past life review in healthy older people. DESIGN 76 older volunteers summarised their lives, highlighting the most important events, impressions and experiences. Cortisol saliva samples were collected on two consecutive weekdays. High and low optimism and pessimism groups were computed by mean split. MAIN OUTCOME MEASURES Percentages of positive (PE) and negative events (NE) and positive (PCE) and negative cognitions and emotions (NCE) were obtained. Optimism and pessimism were measured with the Life Orientation Test Revised. The areas under the curve with respect to the ground and with respect to the increase were computed, with the latter understood as the CAR. RESULTS The high pessimism group reported more NE and NCE and less PE and PCE (p's < 0.041). No significant differences in CAR were found between high and low optimism and pessimism groups after removing suspected non-adherent participants (p's > 0.116). Higher CAR was related to lower PCE, but higher NCE (both p < 0.008). CONCLUSION Pessimism seems to increase the focus on negative aspects of the past, which may lead to a worse perception of life in ageing, whereas optimism contributes to a healthier CAR.
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Affiliation(s)
- S Puig-Perez
- a Health Department of the International University of Valencia , Valencia , Spain.,b Laboratory of Social Cognitive Neuroscience, Department of Psychobiology and IDOCAL , University of Valencia , Valencia , Spain
| | - M M Pulopulos
- b Laboratory of Social Cognitive Neuroscience, Department of Psychobiology and IDOCAL , University of Valencia , Valencia , Spain.,c Department of Experimental Clinical and Health Psychology , Ghent University , Ghent , Belgium
| | - V Hidalgo
- b Laboratory of Social Cognitive Neuroscience, Department of Psychobiology and IDOCAL , University of Valencia , Valencia , Spain.,d Department of Psychology and Sociology, Area of Psychobiology , University of Zaragoza , Teruel , Spain
| | - A Salvador
- b Laboratory of Social Cognitive Neuroscience, Department of Psychobiology and IDOCAL , University of Valencia , Valencia , Spain
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30
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Doolin K, Farrell C, Tozzi L, Harkin A, Frodl T, O'Keane V. Diurnal Hypothalamic-Pituitary-Adrenal Axis Measures and Inflammatory Marker Correlates in Major Depressive Disorder. Int J Mol Sci 2017; 18:E2226. [PMID: 29064428 DOI: 10.3390/ijms18102226] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2017] [Revised: 10/17/2017] [Accepted: 10/18/2017] [Indexed: 02/06/2023] Open
Abstract
Dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis and inflammatory systems is a consistent finding in patients with Major Depressive Disorder (MDD). Cortisol is often assessed by measurement of the cortisol awakening response (CAR) and/or diurnal cortisol levels. Some methods of cortisol measurement overestimate cortisol concentration due to detection of other glucocorticoids including the relatively inert cortisone, therefore this study aimed to assess the presence of both cortisol and cortisone, and the cortisol-cortisone catalyzing enzyme 11β-hydroxysteroiddehydrogenase type 1 (11β-HSD1), in depressed patients and controls. Because the HPA axis is known to regulate the body’s immune system, relationships between measures of cytokines and cortisol were also assessed. Saliva samples were collected from 57 MDD patients and 40 healthy controls at five post-wakening time points (0, +30, +60, +720 and +750 min). Glucocorticoid concentrations were measured by liquid chromatography mass spectrometry. Whole blood mRNA expression of several inflammatory markers was measured by quantitative polymerase chain reaction. This study replicated the common finding of elevated morning cortisol and reduced CAR reactivity in MDD and found no differences in cortisone or 11β-HSD1 mRNA measures. There was a negative association between interleukin 1-β (IL-1β) mRNA and morning cortisol reactivity within the depressed group, indicating that dysregulation of the HPA axis and immune system may be interconnected.
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31
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Vestergaard M, Holm SK, Uldall P, Siebner HR, Paulson OB, Baaré WFC, Madsen KS. Glucocorticoid treatment earlier in childhood and adolescence show dose-response associations with diurnal cortisol levels. Dev Psychobiol 2017; 59:1010-1020. [PMID: 28888057 DOI: 10.1002/dev.21559] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2016] [Accepted: 07/29/2017] [Indexed: 12/29/2022]
Abstract
Heightened levels of glucocorticoids in children and adolescents have previously been linked to prolonged changes in the diurnal regulation of the stress-hormone cortisol, a glucocorticoid regulated by the hypothalamic-pituitary-adrenal-axis (HPA-axis). To address this question, we examined the salivary cortisol awakening response (CAR) and daily cortisol output in 36 children and adolescents (25 girls/11 boys) aged 7-16 years previously treated with glucocorticoids for nephrotic syndrome or rheumatic disorder and 36 healthy controls. Patients and controls did not significantly differ in the CAR or diurnal cortisol output; however, sex-dependent group differences were observed. Specifically, female patients had a higher CAR relative to female controls, while male patients had higher daily cortisol levels compared to male controls. Notably, CAR in female patients and daily cortisol levels in male patients showed a positive linear relationship with the mean daily glucocorticoid doses administered during treatment. The observed dose-response associations suggest that glucocorticoid therapy during childhood and adolescence might trigger long-term changes in HPA-axis regulation, which may differ for males and females.
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Affiliation(s)
- Martin Vestergaard
- Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark.,Psychiatric Research Unit, Region Zealand Psychiatry, Region Zealand, Slagelse, Denmark
| | - Sara K Holm
- Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark.,Neuropaediatric Unit, Department of Paediatrics and Adolescent Medicine, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Peter Uldall
- Neuropaediatric Unit, Department of Paediatrics and Adolescent Medicine, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Hartwig R Siebner
- Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark.,Department of Neurology, Copenhagen University Hospital Bispebjerg, Copenhagen, Denmark
| | - Olaf B Paulson
- Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark.,Neurobiology Research Unit, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.,Center for Integrated Molecular Brain Imaging, Copenhagen, Denmark
| | - William F C Baaré
- Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark
| | - Kathrine S Madsen
- Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark.,Center for Integrated Molecular Brain Imaging, Copenhagen, Denmark.,Department of Technology, Metropolitan University College, Copenhagen, Denmark
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Kuhlman KR, Irwin MR, Ganz PA, Crespi CM, Petersen L, Asher A, Bower JE. Cortisol Awakening Response as a Prospective Risk Factor for Depressive Symptoms in Women After Treatment for Breast Cancer. Psychosom Med 2017; 79:763-9. [PMID: 28570439 DOI: 10.1097/PSY.0000000000000499] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
OBJECTIVE The aim of the study was to investigate hypothalamic-pituitary-adrenal axis (HPA axis) functioning as a neurobiological risk factor for depressive symptoms in an ongoing longitudinal, observational study of women undergoing treatment and recovery from breast cancer. Many women with breast cancer experience depressive symptoms that interfere with their treatment, recovery, and quality of life. Psychosocial risk factors for depression among patients with cancer and survivors have been identified, yet neurobiological risk factors in this population remain largely unexamined. METHODS Women recently diagnosed with early-stage breast cancer (N = 135) were enrolled before starting neoadjuvant/adjuvant treatment (radiation, chemotherapy, endocrine therapy). At baseline, participants collected saliva samples to measure diurnal HPA axis functioning for 3 days: at waking, 30 minutes after waking, 8 hours after waking, and bedtime. Participants also completed a standardized measure of depressive symptoms (Center for Epidemiological Studies-Depression Scale) at baseline and 6 months after completion of primary treatment. Multivariate regression was used to predict continuous depressive symptoms at 6-month posttreatment from continuous depressive symptoms at baseline, cortisol awakening response (CAR), and other measures of diurnal HPA axis functioning. RESULTS The magnitude of CAR predicted changes in depressive symptoms over time, such that women with a higher CAR showed a greater increase from baseline to 6-month posttreatment (b = 5.67, p = .023). Diurnal slope and total cortisol output were not associated with concurrent depressive symptoms or their change over time. CONCLUSIONS Elevated CAR may be a neurobiological risk factor for increases in depressive symptoms in the months after breast cancer treatment and warrants further investigation.
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Vargas I, Mayer S, Lopez-Duran N. The Cortisol Awakening Response and Depressive Symptomatology: The Moderating Role of Sleep and Gender. Stress Health 2017; 33:199-210. [PMID: 27465684 DOI: 10.1002/smi.2691] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2015] [Revised: 06/08/2016] [Accepted: 06/09/2016] [Indexed: 11/07/2022]
Abstract
The association between depression and the cortisol awakening response (CAR) has been widely examined, yet the results are mixed and factors responsible for such inconsistencies are poorly understood. The current study investigated whether the link between depressive symptomatology and CAR varied as a function of two such factors: sleep and gender. The sample included 58 young adults (30 females; Mage = 18.7; SDage = 0.91). Participants completed the Beck Depression Inventory as well as the Consensus Sleep Diary to assess depressive symptomatology and daily sleep patterns, respectively. Participants also provided four salivary cortisol samples (0, 30, 45 and 60 min after awakening) during two consecutive weekdays. Results demonstrated that greater depressive symptoms were associated with a greater CAR but only when depressive symptoms were linked to a shorter sleep time. In addition, gender significantly moderated the association between depressive symptoms and CAR. While greater depressive symptoms were associated with an elevated CAR among females, they were associated with a blunted CAR among males. These findings provide some insight into potential mechanisms linking depressive symptomatology and CAR, and suggest that future studies examining CAR as a biomarker of depression should account for differences in sleep and gender. Copyright © 2016 John Wiley & Sons, Ltd.
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Affiliation(s)
- Ivan Vargas
- Department of Psychology, University of Michigan, Ann Arbor, MI, USA
| | - Stefanie Mayer
- Department of Psychology, University of Michigan, Ann Arbor, MI, USA
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Lyytikäinen K, Toivonen L, Hynynen E, Lindholm H, Kyröläinen H. Recovery of rescuers from a 24-h shift and its association with aerobic fitness. Int J Occup Med Environ Health 2017; 30:433-444. [PMID: 28481376 DOI: 10.13075/ijomeh.1896.00720] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
OBJECTIVES Rescuers work in 24-h shifts and the demanding nature of the occupation requires adequate recovery between work shifts. The purpose of this study has been to find out what kind of changes in autonomic control may be seen during work shift and its recovery period in the case of rescuers. An additional interest has been to see if aerobic fitness is associated with recovery from work shifts. MATERIAL AND METHODS Fourteen male rescuers (aged 34±9 years old) volunteered to participate in the study. Heart rate variability (HRV) was recorded for 96 h to study stress and recovery, from the beginning of a 24-h work shift to the beginning of the next shift. Aerobic fitness assessment included maximal oxygen uptake (VO2max) estimation with a submaximal bicycle ergometer test. Salivary cortisol samples were collected 0 min, 15 min, and 30 min after awakening on the 3 resting days. RESULTS Some HRV parameters showed enhanced autonomic control after the work shift. Stress percentage decreased from the working day to the 2nd rest day (p < 0.05). However, maximal oxygen uptake was not associated with enhanced parasympathetic cardiac control (p > 0.05). Cortisol awakening response was attenuated right after the work shift. CONCLUSIONS The HRV findings show that recovery after a long work shift takes several days. Thus, rescuers should pay attention to sufficient recovery before the next work shift, and an integrated model of perceived and physiological measurements could be beneficial to assess cardiovascular strain among rescuers with long work shifts. Int J Occup Med Environ Health 2017;30(3):433-444.
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Affiliation(s)
- Katariina Lyytikäinen
- University of Jyväskylä, Jyväskylä, Finland (Faculty of Sport and Health Sciences, Department of Biology of Physical Activity).
| | | | - Esa Hynynen
- Research Institute for Olympic Sports, Jyväskylä, Finland.
| | - Harri Lindholm
- Finnish Institute of Occupational Health, Helsinki, Finland.
| | - Heikki Kyröläinen
- University of Jyväskylä, Jyväskylä, Finland (Faculty of Sport and Health Sciences, Department of Biology of Physical Activity).
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Korpa T, Pervanidou P, Angeli E, Apostolakou F, Papanikolaou K, Papassotiriou I, Chrousos GP, Kolaitis G. Mothers' parenting stress is associated with salivary cortisol profiles in children with attention deficit hyperactivity disorder. Stress 2017; 20:149-158. [PMID: 28264636 DOI: 10.1080/10253890.2017.1303472] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
The aim of this study was to explore the relation between mothers' parenting stress and the functioning of the hypothalamic-pituitary-adrenal axis (HPAA), as expressed by daily salivary cortisol concentrations, in their children diagnosed with attention deficit hyperactivity disorder (ADHD). Seventy-five children aged 6-11 years diagnosed with ADHD predominant hyperactive-impulsive/combined (ADHD-HI/C, N = 49) and inattentive symptoms (ADHD-I, N = 26) and 45 healthy peers and their mothers participated in the study. Μothers completed measures assessing their children's ADHD status, perceived parenting stress (Parenting Stress Index - Short Form, PSI-SF), mothers' symptoms of psychopathology, social support and socioeconomic status. Children's salivary cortisol samples were collected at six different time points on a single day. Mothers of children with ADHD-HI/C reported higher levels of parenting stress than mothers of children with ADHD-I and controls. All PSI-SF subscales showed significant associations with children's cortisol awakening response (CAR) in both ADHD groups, with the exception of the parental distress subscale in the ADHD-I group. In both ADHD groups, the parent-child dysfunctional interaction subscale, the difficult child subscale and the PSI total score were significantly associated with children's CAR. An interrelation is revealed between mothers' high levels of parenting stress and HPAA functioning in children with ADHD. In this population, CAR has been identified as a sensitive peripheral measure of HPAA functioning in children. Lay summaryThis study showed that in families of children diagnosed with ADHD, there is a complex relation between the mothers' high levels of parenting stress and children's atypical hypothalamic-pituitary-adrenal axis functioning.
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Affiliation(s)
- Terpsichori Korpa
- a Department of Child and Adolescent Psychiatry , Athens University Medical School, "Aghia Sophia" Children's Hospital: Thivon and Papadiamantopoulou , Athens , Greece
| | - Panagiota Pervanidou
- b Unit of Developmental and Behavioral Pediatrics, First Department of Pediatrics , National and Kapodistrian University of Athens, School of Medicine, "Aghia Sophia' Children's Hospital", Thivon and Papadiamantopoulou , Athens , Greece
| | - Eleni Angeli
- b Unit of Developmental and Behavioral Pediatrics, First Department of Pediatrics , National and Kapodistrian University of Athens, School of Medicine, "Aghia Sophia' Children's Hospital", Thivon and Papadiamantopoulou , Athens , Greece
| | - Filia Apostolakou
- c Department of Clinical Biochemistry , " Aghia Sophia" Children's Hospital: Thivon and Papadiamantopoulou , Athens , Greece
| | - Katerina Papanikolaou
- a Department of Child and Adolescent Psychiatry , Athens University Medical School, "Aghia Sophia" Children's Hospital: Thivon and Papadiamantopoulou , Athens , Greece
| | - Ioannis Papassotiriou
- c Department of Clinical Biochemistry , " Aghia Sophia" Children's Hospital: Thivon and Papadiamantopoulou , Athens , Greece
| | - George P Chrousos
- b Unit of Developmental and Behavioral Pediatrics, First Department of Pediatrics , National and Kapodistrian University of Athens, School of Medicine, "Aghia Sophia' Children's Hospital", Thivon and Papadiamantopoulou , Athens , Greece
| | - Gerasimos Kolaitis
- a Department of Child and Adolescent Psychiatry , Athens University Medical School, "Aghia Sophia" Children's Hospital: Thivon and Papadiamantopoulou , Athens , Greece
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Abstract
Despite the increasing popularity of incorporating salivary cortisol measurement into health and social science research, relatively little empirical work has been conducted on the number of saliva samples across the day required to capture key features of the diurnal cortisol rhythm, such as the diurnal cortisol slope, the area under the curve (AUC), and the cortisol awakening response (CAR). The primary purpose of this study is to compare slope, AUC, and CAR measures obtained from an intensive sampling protocol with estimates from less intensive protocols, to identify sampling protocols with minimal participant burden that still provide reasonably accurate assessment of each of these measures. Twenty-four healthy adults provided samples four times in the first hour awake, and then every hour throughout the rest of the day until bedtime (M = 17.8 samples/day; SD = 2.0), over two consecutive days (N = 862 total samples). We compared measures calculated from this maximum intensity protocol to measures calculated from two to six sampling points per day. Overall, results show that salivary cortisol protocols with two fixed samples (waking and bedtime) and three additional daily samples, closely approximates the full cortisol decline (slope). Abbreviated sampling protocols of total cortisol exposure across the day (AUC), however, were not well approximated by reduced sampling protocols. CAR measures based on only two samples, including waking cortisol and a second sample measured at a fixed time point between 30 and 60 min after waking, provided a measure of the CAR that closely approximated CAR measures obtained from 3 or 4 sampling points.
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Affiliation(s)
| | | | - Heining Cham
- Department of Psychology, Fordham University, Bronx, NY, USA
| | - Emma K. Adam
- Institute for Policy Research, Northwestern University, Evanston, IL, USA
- School of Education and Social Policy, Northwestern University, Evanston, IL, USA
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Ruiz-Robledillo N, Romero-Martínez Á, Moya-Albiol L. Blunted Cortisol Awakening Response and Poor Self-Perceived Health in Informal Caregivers of People with Eating Disorders. Eur Eat Disord Rev 2016; 24:383-90. [PMID: 27188221 DOI: 10.1002/erv.2455] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2015] [Revised: 03/07/2016] [Accepted: 04/15/2016] [Indexed: 01/15/2023]
Abstract
Caring for offspring diagnosed with eating disorders (EDs) entails being under high chronic stress, with negative consequences for health. However, most previous research has only evaluated self-report measures of health, biological markers being poorly studied. In this regard, the evaluation of the cortisol awakening response (CAR) could add significant information about the biological basis of health disturbances in this population. The main aim of the present study was to compare CAR and self-reported health between informal caregivers (ICs) of people with EDs and non-caregivers. Furthermore, we explored the effect of the nature of the diagnosis, comparing ICs of people with anorexia and bulimia nervosa. ICs had a blunted CAR, and more anxiety and insomnia, and social dysfunction, together with poorer perceived general health than non-caregivers. ICs of people with anorexia nervosa had higher levels of morning cortisol and burden, and more social dysfunction and severe depression than those of people with bulimia nervosa. Our results demonstrate marked health problems in ICs of people with EDs, especially when the care recipient has anorexia nervosa. Copyright © 2016 John Wiley & Sons, Ltd and Eating Disorders Association.
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Affiliation(s)
| | - Ángel Romero-Martínez
- Department of Psychobiology, Faculty of Psychology, University of Valencia, Valencia, Spain
| | - Luis Moya-Albiol
- Department of Psychobiology, Faculty of Psychology, University of Valencia, Valencia, Spain
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Romero-Martínez Á, Moya-Albiol L. High Anger Expression is Associated with Reduced Cortisol Awakening Response and Health Complaints in Healthy Young Adults. Span J Psychol 2016; 19:E19. [PMID: 27125918 DOI: 10.1017/sjp.2016.20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
The extant evidence suggests a robust positive association between expression (anger expression-out) and suppression (anger expression-in) of anger and compromised health. Nevertheless, the underlying psychobiological mechanisms which explain these relationships are not well understood. This study examined whether anger expression would predict general health, cortisol awakening response (CAR) and evening cortisol levels in a community sample of 156 healthy young adults of both genders. Participants were distributed into two groups according to their anger expression scores: high and low anger expression (HAE and LAE, respectively). Findings indicated that those with HAE had worse self-reported health (p = .02) and higher CAR than the LAE group (p = .04). Moreover, high levels of anger expression-out (p < .01) and -in (p < .01, for all) predicted a worse self-reported health in both groups. On the other hand, high anger expression-out was associated with flattened CAR but only in the HAE group (p < .01). This study reinforces the need to develop effective strategies to provide mechanisms to regulate anger expression by promoting personal growth and positive skills that enhance individuals' well-being and quality of life and, in turn, their own health.
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Jakuszkowiak-Wojten K, Landowski J, Wiglusz MS, Cubała WJ. Cortisol awakening response in drug-naïve panic disorder. Neuropsychiatr Dis Treat 2016; 12:1581-5. [PMID: 27390521 PMCID: PMC4930225 DOI: 10.2147/ndt.s107547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND It is unclear whether hypothalamic-pituitary-adrenal axis is involved in the pathophysiology of panic disorder (PD). The findings remain inconsistent. Cortisol awakening response (CAR) is a noninvasive biomarker of stress system activity. We designed the study to assess CAR in drug-naïve PD patients. MATERIALS AND METHODS We assessed CAR in 14 psychotropic drug-naïve outpatients with PD and 14 healthy controls. The severity of PD was assessed with Panic and Agoraphobia Scale. The severity of anxiety and depression was screened with Hospital Anxiety and Depression Scale. RESULTS No significant difference in CAR between PD patients and control group was found. No correlations were observed between CAR and anxiety severity measures in PD patients and controls. LIMITATIONS The number of participating subjects was relatively small, and the study results apply to nonsuicidal drug-naïve PD patients without agoraphobia and with short-illness duration. There was a lack of control on subjects' compliance with the sampling instructions. CONCLUSION The study provides no support for elevated CAR levels in drug-naïve PD patients without agoraphobia.
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Affiliation(s)
| | - Jerzy Landowski
- Department of Psychiatry, Medical University of Gdańsk, Gdańsk, Poland
| | - Mariusz S Wiglusz
- Department of Psychiatry, Medical University of Gdańsk, Gdańsk, Poland
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Mossink JCL, Verkuil B, Burger AM, Tollenaar MS, Brosschot JF. Ambulatory assessed implicit affect is associated with salivary cortisol. Front Psychol 2015; 6:111. [PMID: 25713550 PMCID: PMC4322833 DOI: 10.3389/fpsyg.2015.00111] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2014] [Accepted: 01/21/2015] [Indexed: 11/13/2022] Open
Abstract
One of the presumed pathways linking negative emotions to adverse somatic health is an overactive HPA-axis, usually indicated by elevated cortisol levels. Traditionally, research has focused on consciously reported negative emotions. Yet, given that the majority of information processing occurs without conscious awareness, stress physiology might also be influenced by affective processes that people are not aware of. In a 24-h ambulatory study we examined whether cortisol levels were associated with two implicit measures. Implicit affect was assessed using the Implicit Positive and Negative Affect Test, and implicit negative memory bias was assessed with the word fragment completion tasks. In 55 healthy participants, we measured subjective stress levels, worries, implicit, and explicit affect each hour during waking hours. Also, saliva samples were collected at three fixed times during the day, as well as upon waking and 30 min thereafter (cortisol awakening response). Multilevel analyses of the daytime cortisol levels revealed that the presence of an implicit negative memory bias was associated with increased cortisol levels. Additionally, implicit PA and, unexpectedly, implicit NA were negatively associated with cortisol levels. Finally, participants demonstrating higher levels of implicit sadness during the first measurement day, had a stronger cortisol rise upon awakening at the next day. Contrary to previous research, no associations between explicit affect and cortisol were apparent. The current study was the first to examine the concurrent relation between implicit measures and stress physiology in daily life. The results suggest that the traditional focus on consciously reported feelings and emotions is limited, and that implicit measures can add to our understanding of how stress and emotions contribute to daily physiological activity and, in the long term, health problems.
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Affiliation(s)
- Joram C L Mossink
- Clinical Psychology, Faculty of Social Sciences, Leiden University, Leiden Netherlands
| | - Bart Verkuil
- Clinical Psychology, Faculty of Social Sciences, Leiden University, Leiden Netherlands ; Health Psychology, Faculty of Social Sciences, Leiden University, Leiden Netherlands
| | - Andreas M Burger
- Clinical Psychology, Faculty of Social Sciences, Leiden University, Leiden Netherlands
| | - Marieke S Tollenaar
- Clinical Psychology, Faculty of Social Sciences, Leiden University, Leiden Netherlands
| | - Jos F Brosschot
- Health Psychology, Faculty of Social Sciences, Leiden University, Leiden Netherlands
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Abstract
In healthy, non-challenged individuals, the secretion of cortisol typically follows a diurnal profile characterized by a peak in the period following waking (cortisol awakening response) and a gradual decline throughout the day. In addition, cortisol secretion is increased in response to acutely stressful stimuli, particularly stressors involving social evaluation. The current study is the first to assess the impact of an anticipated acute laboratory stressor upon the typical diurnal pattern of HPA activation and relationship to acute cortisol secretion. A sample of 23 healthy young adults provided salivary cortisol samples at four time points (immediately upon awakening, 30-min post-awakening, 1200 h and before bed) on 2 consecutive days. On the second day, participants attended the laboratory and undertook an anticipated acute socially evaluative stressor immediately following provision of their 1200 h saliva sample. Heart rate, blood pressure and mood were recorded immediately before and after the stressor and at 10 and 20 min post-stressor along with additional salivary cortisol samples. Typical patterns of cortisol secretion were observed on both days and exposure to the laboratory stressor was associated with the expected increases in cortisol, heart rate, blood pressure and negative mood. However, significant differences in diurnal cortisol secretion were observed between the two days with greater secretion, in particular, during the period following awakening, evident on the day of the anticipated laboratory stressor. Furthermore, secretion of cortisol during the period following awakening was positively related to secretion during the acute reactivity periods. This is the first study to integrate a laboratory stressor into a typical day and assess its impact on indices of diurnal cortisol secretion in an ambulatory setting. The current findings support the notion that the cortisol awakening response is associated with anticipation of the upcoming day and the subsequent demands required of the individual.
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Affiliation(s)
- Mark A Wetherell
- Stress Research Group, Department of Psychology, University of Northumbria , Newcastle upon Tyne , UK
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Abstract
A relationship between individual differences in trait estimates of the cortisol-awakening response (CAR) and indices of executive function (EF) has been reported. However, it is difficult to determine causality from such studies. The aim of the present study was to capitalise upon state variation in both variables to seek stronger support for causality by examining daily co-variation. A 50 days researcher-participant case study was employed, ensuring careful adherence to the sampling protocol. A 24-year-old healthy male collected saliva samples and completed an attention-switching index of EF on the morning of each study day. Subsidiary control measures included wake time, sleep duration, morning fatigue, and amount of prior day exercise and alcohol consumption. As the CAR preceded daily measurement of EF, we hypothesised that, over time, a greater than average CAR would predict better than average EF. This was confirmed by mixed regression modelling of variation in cortisol concentrations, which indicated that the greater the increase in cortisol concentrations from 0 to 30 min post-awakening (CAR) the better was subsequent EF performance at 45 min post-awakening (t = 2.29, p = 0.024). This effect was independent of all potential confounding measures. Results are discussed in terms of implications for the understanding of the relationship between the CAR and the cognitive function, and the previously suggested role of the CAR in "boosting" an individual's performance for the day ahead.
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Affiliation(s)
- Robin Law
- a Psychophysiology and Stress Research Group, Department of Psychology, University of Westminster , London , UK
| | - Phil Evans
- a Psychophysiology and Stress Research Group, Department of Psychology, University of Westminster , London , UK
| | - Lisa Thorn
- a Psychophysiology and Stress Research Group, Department of Psychology, University of Westminster , London , UK
| | - Frank Hucklebridge
- a Psychophysiology and Stress Research Group, Department of Psychology, University of Westminster , London , UK
| | - Angela Clow
- a Psychophysiology and Stress Research Group, Department of Psychology, University of Westminster , London , UK
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Tell D, Mathews HL, Janusek LW. Day-to-day dynamics of associations between sleep, napping, fatigue, and the cortisol diurnal rhythm in women diagnosed as having breast cancer. Psychosom Med 2014; 76:519-28. [PMID: 25186656 DOI: 10.1097/PSY.0000000000000097] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
OBJECTIVES To examine whether day-to-day variations in sleep behaviors, ongoing sleep disturbance, and fatigue predict the cortisol diurnal rhythm in women recently diagnosed as having early-stage breast cancer. METHODS Women (N = 130, mean [standard deviation] age = 55.6 [9.4] years) collected saliva 5×/day/2 days for cortisol. Diaries were used to assess prior-day nap duration, nocturnal awakenings, sleep latency, and morning restfulness. Ongoing fatigue and sleep disturbance were measured using the Multidimensional Fatigue Symptom Inventory and the Pittsburg Sleep Quality Inventory. Data were analyzed using a multilevel growth curve modeling. RESULTS Greater ongoing fatigue (b = 0.035, p = .032), or sleep disturbance (b = 0.026, p = .006) predicted a slower cortisol decline. Greater ongoing fatigue also predicted higher awakening cortisol (b = 0.154, p = .030) and lower cortisol awakening response (CAR; b = -0.146, p = .005). Longer prior-day naps predicted higher CAR (b = 0.042, p = .050) and a steeper cortisol decline (b = -0.035, p = .003). Longer sleep latency predicted both a greater cortisol linear decline (b = -0.013, p < .001) and a greater quadratic slope curvature (b = 0.0007, p < .001). Feeling less rested in the morning predicted lower awakening cortisol (b = -0.187, p = .004), higher CAR (b = 0.124, p = .016), and a slower cortisol decline (b = 0.023, p = .042). CONCLUSIONS Both daily variations in sleep behaviors and ongoing sleep disturbance and fatigue are associated with a disrupted cortisol rhythm. In contrast, prior-day napping is associated with a more robust cortisol rhythm. These findings are particularly relevant to women with breast cancer who often experience sleep disturbance and fatigue. Additional research is needed to determine causal pathways between sleep disturbance and dysregulation of the hypothalamic-pituitary-adrenal axis in patients with breast cancer.
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Moriarty AS, Bradley AJ, Anderson KN, Watson S, Gallagher P, McAllister-Williams RH. Cortisol awakening response and spatial working memory in man: a U-shaped relationship. Hum Psychopharmacol 2014; 29:295-8. [PMID: 24911579 DOI: 10.1002/hup.2399] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2013] [Revised: 01/18/2014] [Accepted: 02/03/2014] [Indexed: 11/06/2022]
Abstract
OBJECTIVE The association between hypothalamic-pituitary-adrenal (HPA)-axis function and cognition has long been investigated. An inverted U-shaped relationship has been described between various measures of HPA-axis function and neuropsychological performance in animals and man. Work with glucocorticoid receptor manipulation has corroborated these findings, with particular effects observed in relation to spatial working memory (SWM). As HPA-axis dysfunction is frequently found in patients with psychiatric illness, research in this area has potential implications for the treatment of the commonly observed cognitive impairment in such disorders. Here, we present the results of a pilot study examining the relationship between cortisol awakening response (CAR) and cognitive functions known to be susceptible to HPA-axis manipulation. METHODS Nineteen healthy male volunteers were recruited, and their CAR and performance in a task of SWM were assessed. RESULTS A highly significant quadratic relationship was observed between the CAR and SWM error rate (R(2)=0.63, p=0.001). CONCLUSION We provide novel evidence supporting the existence of an inverted U-shaped relationship between corticosteroid levels and cognitive function in humans.
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Affiliation(s)
- Andrew S Moriarty
- Institute of Neuroscience, Newcastle University, Academic Psychiatry, Campus for Ageing and Vitality, Newcastle upon Tyne, UK
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Bright MA, Frick JE, Out D, Granger DA. Individual differences in the cortisol and salivary α-amylase awakening responses in early childhood: relations to age, sex, and sleep. Dev Psychobiol 2014; 56:1300-15. [PMID: 24604597 DOI: 10.1002/dev.21209] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2013] [Accepted: 01/27/2014] [Indexed: 12/28/2022]
Abstract
Recent studies have examined post-waking changes in cortisol as a marker of HPA functioning, but questions remain about the stability of this response, as well as its relation to sleep and other ANS markers. The purposes of this study were to a) examine the presence and developmental changes in the cortisol awakening response (CAR) and salivary α-amylase awakening (sAA-AR) in a toddler sample and b) determine whether and how sleep relates to these responses in this age group. We measured cortisol and sAA upon awakening (and 30 min post-waking) and sleep characteristics using actigraphy (e.g., total sleep time, sleep efficiency, number of awakenings) in toddlers (N = 47; 36% female, ages 12-24 months). Forty-six percent of toddlers demonstrated a CAR and 52% demonstrated a sAA-AR. Strength of either response did not change linearly with age. Additionally, likelihood of demonstrating the CAR and sAA-AR was unrelated to age, sex, awakening time, time between samples, and time since feeding. Higher waking cortisol levels were associated with a shorter total sleep time and an earlier awakening. No associations were observed between sleep characteristics and the sAA-AR, ps > .05. Our findings suggest that these awakening responses function independently of sleep in toddlers. Additionally, the lack of change in percentage of children showing a CAR or sAA-AR across these ages suggests that these responses are stable and not emerging reliably across the second year of life.
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Affiliation(s)
- Melissa A Bright
- Institute for Child Health Policy, University of Florida, Gainesville, FL
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Michels N, Sioen I, Clays E, De Buyzere M, Ahrens W, Huybrechts I, Vanaelst B, De Henauw S. Children's heart rate variability as stress indicator: association with reported stress and cortisol. Biol Psychol 2013; 94:433-40. [PMID: 24007813 DOI: 10.1016/j.biopsycho.2013.08.005] [Citation(s) in RCA: 98] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2012] [Revised: 08/25/2013] [Accepted: 08/25/2013] [Indexed: 11/22/2022]
Abstract
UNLABELLED Stress is a complex phenomenon coordinated by two main neural systems: the hypothalamic-pituitary-adrenal system with cortisol as classical stress biomarker and the autonomic nervous system with heart rate variability (HRV) as recently suggested stress marker. To test low HRV (5 minute measurements) as stress indicator in young children (5-10 y), associations with self-reported chronic stress aspects (events, emotions and problems) (N=334) and salivary cortisol (N=293) were performed. Peer problems, anger, anxiety and sadness were associated with lower root mean square of successive differences (RMSSD) and high frequency power (i.e. lower parasympathetic activity). Anxiety and anger were also related to a higher low frequency to high frequency ratio. Using multilevel modelling, higher cortisol levels, a larger cortisol awakening response and steeper diurnal decline were also associated with these HRV patterns of lower parasympathetic activity. CONCLUSION Low HRV (lower parasympathetic activity) might serve as stress indicator in children.
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Hajat A, Diez-Roux AV, Sánchez BN, Holvoet P, Lima JA, Merkin SS, Polak JF, Seeman T, Wu M. Examining the association between salivary cortisol levels and subclinical measures of atherosclerosis: the Multi-Ethnic Study of Atherosclerosis. Psychoneuroendocrinology 2013; 38:1036-46. [PMID: 23146655 PMCID: PMC4020284 DOI: 10.1016/j.psyneuen.2012.10.007] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2012] [Revised: 09/01/2012] [Accepted: 10/08/2012] [Indexed: 01/31/2023]
Abstract
OBJECTIVE To investigate the association between salivary cortisol and two markers of subclinical cardiovascular disease (CVD), coronary calcification (CAC), and ankle-brachial index (ABI). METHODS Data from an ancillary study to the Multi-Ethnic Study of Atherosclerosis (MESA), the MESA Stress Study, were used to analyze associations of salivary cortisol data collected six times per day over three days with CAC and ABI. The authors used mixed models with repeat cortisol measures nested within persons to determine if specific features of the cortisol profile were associated with CAC and ABI. RESULTS A total of 464 participants were included in the CAC analysis and 610 in the ABI analysis. The mean age of participants was 65.6 years. A 1-unit increase in log coronary calcium was associated with a 1.77% flatter early decline in cortisol (95% CI: 0.23, 3.34) among men and women combined. Among women low ABI was associated with a steeper early decline (-13.95% CI: -25.58, -3.39) and a marginally statistically significant flatter late decline (1.39% CI: -0.009, 2.81). The cortisol area under the curve and wake to bedtime slope were not associated with subclinical CVD. CONCLUSIONS This study provides weak support for the link between cortisol and measures of subclinical atherosclerosis. We found an association between some features of the diurnal cortisol profile and coronary calcification and ABI but associations were not consistent across subclinical measures. There are methodological challenges in detecting associations of cortisol measures at a point in time with health outcomes that develop over a lifetime. Studies of short-term mechanisms linking stress to physiological processes related to the development of early atherosclerosis may be more informative.
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Affiliation(s)
- Anjum Hajat
- University of Washington, Department of Environmental & Occupational Health Sciences, Seattle, WA 98102, United States.
| | | | | | - Paul Holvoet
- Katholieke Universiteit Leuven, Department of Cardiovascular Disease
| | - João A. Lima
- Johns Hopkins University, Department of Cardiology
| | | | - Joseph F. Polak
- Tufts University, School of Medicine, Department of Radiology
| | - Teresa Seeman
- University of California Los Angeles, Division of Geriatrics
| | - Meihua Wu
- University of Michigan, Department of Biostatistics
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Hartman CA, Hermanns VW, de Jong PJ, Ormel J. Self- or parent report of (co-occurring) internalizing and externalizing problems, and basal or reactivity measures of HPA-axis functioning: a systematic evaluation of the internalizing-hyperresponsivity versus externalizing-hyporesponsivity HPA-axis hypothesis. Biol Psychol 2013; 94:175-84. [PMID: 23735709 DOI: 10.1016/j.biopsycho.2013.05.009] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2012] [Revised: 04/28/2013] [Accepted: 05/14/2013] [Indexed: 11/17/2022]
Abstract
BACKGROUND Previous research findings on the link between adolescents' psychopathology and hypothalamic-pituitary-adrenal (HPA) axis activity have been heterogeneous. METHOD Adolescents (n=211) with a preadolescent DSM-IV diagnosis participated in a lab-based social stress task. Saliva cortisol was assessed at awakening and during social stress. It was investigated if continuous measures of internalizing and externalizing problems and their interaction, using both self- and parent report, were associated with basal or reactivity measures of HPA-axis functioning. RESULTS During social stress, an enhanced total release of cortisol was associated with self-reported internalizing problems and a blunted total release of cortisol with self-reported externalizing problems. Post hoc analyses revealed that the association between enhanced cortisol output and internalizing problems held for boys but not for girls. Associations with morning cortisol measures were overall weak. CONCLUSIONS Only in the context of stress, and particularly when based on self-report, blunted cortisol output was associated with externalizing and enhanced cortisol output with internalizing problems. Our broad approach demonstrates the importance of who reports on psychopathology, the use of dimensional measures of psychopathology, simultaneous analysis of internalizing and externalizing problems, and the use of awakening and social stress related measures of cortisol.
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Affiliation(s)
- Catharina A Hartman
- Interdisciplinary Center for Psychiatric Epidemiology, Department of Psychiatry, University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9700 RB Groningen, The Netherlands.
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Abstract
Altered cortisol has been demonstrated to be lower in those with posttraumatic stress disorder (PTSD) in most studies. This cross-sectional study evaluated salivary cortisol at waking and 30 minutes after, and at bedtime in 51 combat veterans with PTSD compared to 20 veterans without PTSD. It also examined the relationship of cortisol to PTSD symptoms using 2 classifications: the Diagnostic and Statistical Manual of Mental Disorders (4th ed., DSM-IV; American Psychiatric Association, 1994) and the more recent 4-factor classification proposed for DSM-5. The PTSD group had lower cortisol values than the control group, F(6, 69) = 3.35, p = .006. This significance did not change when adding age, body mass index, smoking, medications affecting cortisol, awakening time, sleep duration, season, depression, perceived stress, service era, combat exposure, and lifetime trauma to the model. Post hoc analyses revealed that the PTSD group had lower area-under-the-curve ground and waking, 30 min, and bedtime values; the cortisol awakening response and area-under-the-curve increase were not different between groups. The 4-factor avoidance PTSD symptom cluster was associated with cortisol, but not the other symptom clusters. This study supports the finding that cortisol is lower in people with PTSD.
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Affiliation(s)
- Helané Wahbeh
- Department of Neurology, Oregon Health & Science University, Portland, OR 97239, USA.
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Vrshek-Schallhorn S, Doane LD, Mineka S, Zinbarg RE, Craske MG, Adam EK. The cortisol awakening response predicts major depression: predictive stability over a 4-year follow-up and effect of depression history. Psychol Med 2013; 43:483-493. [PMID: 22652338 PMCID: PMC3500423 DOI: 10.1017/s0033291712001213] [Citation(s) in RCA: 145] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND The cortisol awakening response (CAR) has been shown to predict major depressive episodes (MDEs) over a 1-year period. It is unknown whether this effect: (a) is stable over longer periods of time; (b) is independent of prospective stressful life events; and (c) differentially predicts first onsets or recurrences of MDEs. METHOD A total of 270 older adolescents (mean age 17.06 years at cortisol measurement) from the larger prospective Northwestern-UCLA Youth Emotion Project completed baseline diagnostic and life stress interviews, questionnaires, and a 3-day cortisol sampling protocol measuring the CAR and diurnal rhythm, as well as up to four annual follow-up interviews of diagnoses and life stress. RESULTS Non-proportional person-month survival analyses revealed that higher levels of the baseline CAR significantly predict MDEs for 2.5 years following cortisol measurement. However, the strength of prediction of depressive episodes significantly decays over time, with the CAR no longer significantly predicting MDEs after 2.5 years. Elevations in the CAR did not significantly increase vulnerability to prospective major stressful life events. They did, however, predict MDE recurrences more strongly than first onsets. CONCLUSIONS These results suggest that a high CAR represents a time-limited risk factor for onsets of MDEs, which increases risk for depression independently of future major stressful life events. Possible explanations for the stronger effect of the CAR for predicting MDE recurrences than first onsets are discussed.
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