What makes for a good break? A diary study on recovery experiences during lunch break

This study investigated the role of four recovery experiences during lunch break for employees’ afternoon well‐being. We hypothesized that lunch‐break recovery experiences (psychological detachment, relaxation, control, and relatedness) reduce afternoon exhaustion and enhance afternoon work engagement via replenished personal resources (i.e., state of being recovered immediately after break and subsequent self‐efficacy regarding the upcoming tasks in the afternoon). One hundred and nine employees provided daily survey data three times a day (i.e., start of work, after lunch break, end of work) over a period of two workweeks. Multilevel path analysis showed that relaxation, control, and relatedness during lunch break negatively predicted afternoon exhaustion and positively predicted afternoon work engagement via state of being recovered. For relaxation and relatedness, we additionally found positive serial indirect effects on afternoon work engagement via state of being recovered and self‐efficacy. Psychological detachment was not related to personal resources and afternoon well‐being. This study demonstrates that experiencing control over lunch break and using the lunch break to relax and to relate to others are indirectly associated with improved afternoon well‐being via replenished personal resources.

Practitioner points

• Relaxation, control, and relatedness constitute lunch‐break recovery experiences that indirectly foster feeling confident, replenished, and engaged in the afternoon.
• Employees should strive to spend their lunch breaks in ways that help them feel relaxed, related, and in control.
• Organizations should provide their employees with sufficient break control and offer environments that facilitate relaxation and socializing during lunch break.

     

A follow-up of cognitive performance and diurnal salivary cortisol changes in former burnout patients

The purpose of this study was to determine whether recovery from burnout is associated with improved cognitive functioning, and whether such improvement is associated with changes in hypothalamic-pituitary-adrenal axis activity and return to work. Forty-five former burnout patients were followed up after 1.5 years with a neuropsychological examination, diurnal salivary cortisol measurements, dexamethasone suppression test (DST), and self-ratings of cognitive problems. At follow-up, improved cognitive performance was observed on several tests of short-term memory and attention. Self-rated cognitive problems decreased considerably, but this decrease was unrelated to the improvement on neuropsychological tests. Diurnal salivary cortisol concentrations at awakening, 30?min after awakening, and in the evening, did not change from baseline to follow-up, nor did the cortisol awakening response. However, slightly, but significantly, stronger suppression of cortisol in response to the DST was observed at follow-up. Improvements in subjective or objective cognitive functioning and changes in diurnal cortisol concentration were unrelated to the extent of work resumption. However, a decreased DST response at follow-up was partially related to improved cognitive performance and work resumption. The clinical implications are that burnout seems to be associated with slight and significantly reversible cognitive impairment, and that self-rated cognitive change during recovery poorly reflects objective cognitive change.     

Adolescent Personality: Associations With Basal,Awakening, and Stress‐Induced Cortisol Responses

The purpose of the present study was to investigate the associations between personality facets and hypothalamic‐pituitary‐adrenal (HPA) axis functioning. Previous studies have mainly focussed on stress‐induced HPA‐axis activation. We hypothesized that other characteristics of HPA‐axis functioning would have a stronger association with personality based on the neuroendocrine literature. Data (n = 343) were used from the TRacking Adolescents' Individual Lives Survey (TRAILS), a large prospective cohort study of Dutch adolescents. We studied the association between facets of Neuroticism, Extraversion, and Conscientiousness and basal cortisol, the cortisol awakening response (CAR), and four measures of stress‐induced HPA‐axis activity. Basal cortisol levels were related to facets of all three personality traits. The CAR and stress‐induced cortisol were not related to personality. Possibly due to its more trait‐like nature, basal cortisol seems more informative than stress‐induced cortisol when investigating trait‐like characteristics such as personality facets.     

Mini‐breaks: the use of escape on a fixed‐time schedule to reduce unauthorized breaks from vocational training sites for individuals with brain injury

This study evaluated mini‐breaks with three individuals who were traumatically brain injured and engaged in unauthorized breaks. The vocational instructors reported that the three participants were having problems staying at their scheduled vocational training sites (walking away without permission). Following baseline, participants were placed on mini‐breaks; that is, participants were given a ten‐minute mini‐break every hour. Thus, mini‐breaks were given without regard to unauthorized breaks. Unauthorized breaks decreased to zero levels for all three participants when mini‐breaks commenced. Following 1 month of the mini‐breaks, two of the participants were put back on a regular break schedule (one 15‐minute AM break and one 15‐minute PM break and a 30‐minute lunch break). The third participant was placed in supported work. The effects of the mini‐breaks were maintained. Copyright © 1999 John Wiley & Sons, Ltd.     

The cortisol awakening response and the big five personality dimensions

The present study investigated the association between the big five personality dimensions and the cortisol awakening response (CAR), a physiological parameter reflective of HPA axis activity. One hundred and seven participants completed the big five inventory (BFI; John, Donahue, & Kentle, 1991) and collected salivary cortisol samples at 0, 30, and 60 min after awakening on a weekday morning. The cortisol awakening response under the curve (CARauc) and the cortisol awakening response with respect to increase (CARi) were used as outcome variables in the statistical analyses. Hierarchical linear regression analyses were conducted using the data of 92 participants. Gender and age were included as covariates in block one of the regressions, followed by the personality dimensions in block two. Extraversion emerged as a significant predictor of CARauc. No other personality dimensions were significantly predictive of CARauc or CARi. Interestingly, gender emerged as the strongest predictor in the CARauc, with females exhibiting greater cortisol release across the awakening period than males. Our results suggest that extraversion and gender may be particularly important variables to consider in the regulation of the HPA axis.     

Abnormal diurnal pattern of cortisol secretion in patients after aneurysmal subarachnoid hemorrhage

Substantial evidence suggests that impairment of the hypothalamus?pituitary system can occur following an aneurysmal subarachnoid hemorrhage (aSAH). Given that the diurnal cortisol rhythm is primarily controlled by the hypothalamus?pituitary system, this study examined whether changes in diurnal cortisol rhythm occurred after aSAH. Cortisol concentrations were measured in the saliva samples collected from patients after aSAH and other types of cerebral hemorrhage (non-aSAH) in the post-awakening period and at night (21:00?h), and the cortisol awakening response (CAR) and diurnal cortisol decline were determined. The area under the cortisol curve from immediately after to 45?min after awakening (CARauc) in the aSAH patient group was comparable to that in the non-aSAH or healthy control groups. However, an obvious cortisol peak was not found after the awakening period, and the morning/nighttime cortisol ratio in the aSAH patient group was significantly lower than that in other examined groups due to higher nighttime cortisol concentrations. In aSAH patients, the CARauc and nighttime cortisol concentrations were negatively correlated with the Fisher CT grade. These results indicate that the diurnal cortisol rhythm is not regulated normally after aSAH, and cortisol secretory activity decreases as the volume of subarachnoid bleeding increases. Our findings will be helpful to understand altered hypothalamus?pituitary?adrenal axis function after aSAH.     

Correlation between maternal and infant cortisol varies by breastfeeding status

ObjectiveThe objective of this study was to examine associations of mother and infant salivary cortisol, measured three times over the course of a day, and assess whether these varied by breastfeeding status.MethodsWe conducted a cross-sectional study of 54 mothers and their infants aged 4–11 months. Mothers collected their own saliva and that of their infants upon awakening, 30 min after waking and at bedtime. Breastfeeding status was reported by mothers and cortisol level was measured in saliva in μg/dl using standard techniques. We used generalized linear models to evaluate relationships between maternal and infant cortisol levels, and assessed whether the relationship differed by breastfeeding status: formula only compared to partial and full breastfeeding, adjusting for infant sex, race, age, maternal education, and family income.ResultsThirty-four infants received formula only and 20 were either partially or fully breastfed. Breastfeeding was associated with higher household income, higher maternal education, and white race. Cortisol levels were higher among breastfed infants at all three time points. After adjustment, maternal cortisol levels were related with infant cortisol at bedtime only (regression estimate 0.06; 95% CI: 0.10, 1.1; p = 0.02). The adjusted association between bedtime maternal and infant cortisol was stronger among breastfeeding dyads than among formula-feeding dyads (regression estimate 1.0; 95% CI: 0.1, 2.0; p = 0.04 vs. 0.6; CI: −0.1, 1.3; p = 0.10). In addition, we assessed the influence of maternal education and household income in our adjusted model; income strengthened the observed association, whereas maternal education did not change the estimate.ConclusionsBreastfeeding mothers and infants had significant correlations for cortisol at bedtime, while formula-feeding dyads did not. These data suggest that several factors may contribute to cortisol synchrony observed in mother/infant dyads, including the transfer of cortisol in human milk, physical interaction such as skin-to-skin contact, and shared environment. In addition, our findings support household income as a possible contributor.     

Feeding upon awakening in breastfeeding and bottlefeeding mothers does not affect the awakening cortisol response

An acute breastfeeding stimulus is generally followed by a transient decrease in cortisol levels in mothers. It is currently not clear whether breastfeeding upon waking up would affect the awakening cortisol response (ACR), a significant increase in salivary cortisol levels occurring within 30-45 min after awakening. In the present study, we measured the amplitude and stability of the ACR in response to infant feeding in women who were exclusively bottle-feeding (n = 16), or breastfeeding (n = 13) or feeding their child solid food (n = 12). The results show that the type of infant feeding did not affect the amplitude and stability of the ACR. Given that the ACR has been reported to reflect physical and psychological well-being, our finding that infant feeding upon waking up might not be a confounding factor in ACR studies on the postpartum population represents valuable methodological information.     

The awakening cortisol response: methodological issues and significance

The awakening cortisol response (ACR) is a discrete and distinctive part of the cortisol circadian cycle. In healthy adults salivary free cortisol concentrations increase by between 50 and 160% in the first 30 min immediately post-awakening (approximate average increase of 9 nmol/l, range 4-15 nmol/l, estimated to be equivalent to about three secretory episodes). However there are no agreed norms for the absolute concentrations of free cortisol in saliva either immediately post-awakening (range of 4.7-18.5 nmol/l) or 30 min post-awakening (range of 8.6-21.9 nmol/l). This review explores reasons for these discrepancies in normative data including confounding factors such as gender, age, awakening time, light and participant adherence. Although the physiological role of the ACR has not been clearly defined evidence is discussed that suggests it is under a distinct regulatory influence, different from the rest of the diurnal cortisol secretory cycle. Despite the difficulties associated with its measurement a range of studies have demonstrated an association between the ACR and psychosocial variables, stress and health. However it remains unclear whether positive affect and good health are consistently associated with larger or smaller awakening responses. It is early days in the search for the role and significance of the ACR. Its putative role in the regulation of physiological function across the day (e.g. the immune system) and its sensitivity to psychosocial variables make it a prime candidate as an intermediary linking mind and health.     

The cortisol awakening response: Associations with trait anxiety and stress reactivity

This study investigated the extent to which trait anxiety and state anxiety in response to stress are associated with the cortisol awakening response (CAR).Fifty-one healthy participants were recruited. State anxiety measures were taken in anticipation of and during a laboratory stressor. Salivary cortisol levels were measured immediately upon awakening (at 0, 15, 30, and 45 min) on two consecutive mornings. Cortisol awakening response was assessed by the area under the curve with respect to zero (AUC_G).The magnitude of the CAR was found to be negatively associated with both trait anxiety and anticipatory anxiety. Moreover, regression analysis showed that the effects of trait anxiety on the AUC_G were mediated by anticipatory anxiety.These results suggest that the CAR is influenced by trait anxiety. Moreover, the effect of trait anxiety on the CAR seems to operate by impacting on psychological stress reactivity (i.e., anticipatory anxiety).     

C-reactive protein polymorphisms are associated with the cortisol awakening response in basal conditions in human subjects

Cortisol affects the acute-phase response, but it is unknown whether C-reactive protein (CRP), an acute-phase reactant, also affects hypothalamus?pituitary?adrenal axis activity. In the present study, associations were explored between CRP haplotypes with plasma CRP concentrations and basal salivary cortisol level. We included 266 physically healthy Caucasian subjects (103 females and 163 males) aged between 18 and 65 years of whom 94 had a psychiatric disorder in a genetic association study. Six tag single-nucleotide polymorphisms capturing the common genetic variation of the CRP gene were genotyped (i.e. rs2808628, rs2808630, rs1205, rs1800947, rs1417938, and rs3091244) to yield common CRP haplotypes. Plasma CRP concentrations, the salivary cortisol awakening response (CAR) (0, 30, 45, and 60?min after awakening), and the diurnal cortisol decline (11:00, 15:00, 19:00, and 23:00 h) were assessed for 2 days. rs2808628, rs1205, rs1417938, and rs3091244 showed expected associations not only with CRP concentrations, but also with salivary cortisol levels during the CAR. Five well-characterized CRP haplotypes were arranged in ascending order according to increasing CRP levels. There was an inverse linear association between CRP haplotypes and cortisol levels during the CAR, but no association with the diurnal cortisol decline. Hence, genetic variants in the CRP gene that are associated with lifetime plasma CRP levels were also associated with salivary cortisol levels after awakening, in basal, non-inflammatory conditions.     

Choose your lunch companion wisely: the relationships between lunch break companionship,psychological detachment,and daily vigour

This diary study examines psychological detachment, companionship, and content of conversation during lunch break as predictors of daily vigour after lunch break and at the end of the working day. Drawing on resource regulation theory and the effort recovery model (ERM), we hypothesize that companionship of the supervisor during lunch break is negatively and companionship of colleagues positively related to employee’s daily vigour. The companionship of both, supervisors and colleagues, as well as work-related conversations are hypothesized to decrease psychological detachment during lunch breaks. In total, 71 persons in administrative jobs completed daily surveys over one working week. Results of hierarchical linear modelling showed that psychological detachment is positively related to vigour after lunch break, but unrelated to vigour at the end of the working day. Lunch breaks with the supervisor predicted a lower level of vigour at the end of the working day, but a higher level of vigour after lunch break. Lunch breaks with colleagues were unrelated to vigour after lunch break, but associated with higher vigour at the end of a working day. The companionship of both—colleagues and supervisors—as well as work-related conversation decreased psychological detachment during lunch break.     

Perceived stress,recurrent pain,and aggregate salivary cortisol measures in mid‐adolescent girls and boys

Measures of perceived stress have been criticized for theoretical inconsistency. However, the validated pressure activation stress scale has been suggested as a theoretically sound alternative. But it is unclear how pressure and activation stress relate to objective and subjective measures including commonly used aggregate cortisol measures and health complaints respectively. Specifically, this study aimed at investigating how pressure and activation stress were related to aggregate salivary cortisol measures and recurrent pain in mid‐adolescent girls and boys. Mid‐adolescents (119 girls and 56 boys) provided self‐reports in questionnaires on activation and pressure stress and recurrent pain (headache, stomach ache, neck/shoulder and back pain). Additionally, adolescents sampled saliva during an ordinary school day: (1) immediately at awakening; (2) 30 minutes after waking up; (3) 60 minutes after waking up, and (4) at 8 p.m. These samples were analyzed for cortisol. Hierarchical regressions showed no statistically significant associations between activation and pressure stress and cortisol, neither for girls nor for boys. However, activation and pressure stress were significantly associated with recurrent pain but only for girls. The findings may relate to subjective and objective measures reflecting distinct aspects of stress‐related functioning. However, the study participants included mid‐adolescents whose bodily systems are flexible and still relatively unaffected by the strain of their daily stress perceptions. To conclude, the non‐significant relationships between activation and pressure stress and commonly used aggregate measures of cortisol adds to the understanding of how perceived stress may relate to physiological functioning in the daily life of adolescents when using such aggregate measures.     

Saliva DHEAS changes in patients suffering from psychopathological disorders arising from bullying at work

BACKGROUND: Psychological disorders arising from bullying at work (BW) are common. The relationship between these disorders and putative markers is not well established. AIMS: To measure saliva dehydroepiandrosterone sulphate (DHEAS) and saliva cortisol as putative markers in individuals suffering from BW. METHODS: Forty one subjects suffering from BW were screened for mental distress at the institute of occupational health in Clermont-Ferrand, France. They were compared with 28 psychologically healthy controls (group C). The conditions causing BW were recorded. The hospital anxiety and depression (HAD) scale, the Beech questionnaire and the visual analogic scale (VAS) of stress were used to determine the psychological consequences of BW. Saliva samples were collected at awakening (7am), 30 and 60min after awakening, and then every 2h until bed time (11pm). RESULTS: The BW group had significantly higher scores on the HAD scale, higher stress on the VAS, and a higher score on the Beech questionnaire. They also had a significantly higher saliva concentration of DHEAS. There was no significant difference between groups in cortisol levels at any time, nor in area under the curve (AUC) and cortisol awakening response (CAR). There was a significant positive correlation between HAD and VAS scores and DHEAS levels, but not between cortisol levels or AUC or CAR. CONCLUSION: In contrast to saliva cortisol levels, saliva DHEAS levels are modified after psychological distress arising from BW. This discrepancy probably arises from the stability conferred by the very long half life of DHEAS of about 15h.     

Diurnal patterns of salivary cortisol and DHEA in adolescent anorexia nervosa

Although there is well-documented evidence for hyperactivity of hypothalamic-pituitary-adrenal (HPA) axis function in anorexia nervosa (AN), there has been little research into secretory patterns of salivary cortisol and dehydroepiandrosterone (DHEA) in this condition. The cortisol awakening response (CAR), a prominent and discrete feature of the cortisol cycle, has not been extensively explored in adolescent AN. Saliva samples were collected at awakening, 30?min and 12 h post-awakening on two consecutive weekdays from eight female adolescents with clinically diagnosed AN and 41 healthy control (HC) age-matched females. Adolescent AN patients had greater salivary cortisol and DHEA concentrations than HC girls at all points. Increased hormone secretion was unrelated to body mass index. However, despite hypersecretion of both hormones, the circadian pattern including the CAR paralleled that of the HC group. Findings from this preliminary study confirm dysregulation of HPA axis function in adolescent AN as evidenced by hypersecretion of both cortisol and DHEA, which share the common secretagogue adrenocorticotropic hormone. However, the parallel diurnal profiles for AN and HC participants, including the CAR, may indicate hypersecretion per se rather than differential regulation of the diurnal pattern of these two adrenal steroids in AN.     

Cortisol and symptoms of psychopathology in Russian and American college students

Cortisol is a key player in the hypothalamus-pituitary-adrenal (HPA) axis response to stress, and has been related to symptoms of depression and other stress-related pathology. The present study investigated the relationship between cortisol and survey measures of stress and psychopathology as well as lifestyle in Russian and American college students. Salivary cortisol was collected upon awakening, 30 min later, at 4 p.m., and at 10 p.m. by Russian and American college students. Survey measures of anxiety and depression, as measured by the Hopkins Symptom Checklist (HSCL-25) were collected as well as scores on the Trauma History Questionnaire (THQ). In addition, measures of drinking-related problems, as measured by the Alcohol Use Disorder Identification Test (AUDIT) and the "Cut down, Annoyed, Guilty, Eye-opener" (CAGE) were also completed. Consistent with the typically observed empirical pattern, cortisol levels increased in the 30 min after awakening and then declined across the day. Women reported more symptoms of anxiety than did men in both Russian and American samples. American students reported more symptoms of depression than did Russian students, though Russian students reported more traumatic life experiences. Americans had higher cortisol levels overall, though Russian students had larger changes in cortisol levels across the day, associated with both greater morning rises and afternoon declines in cortisol. While more Russian students reported smoking, American students reported more problems associated with alcohol use as measured by the AUDIT. The relationship between stress and health, mediating factors of lifestyle and coping, and the impact of social transition in Russia are discussed.     

The role of awakening cortisol and psychological distress in diurnal variations in affect: a day reconstruction study

People often feel unhappy in the morning but better later in the day, and this pattern may be amplified in the distressed. Past work suggests that one function of cortisol is to energize people in the morning. In a study of 174 students, we tested to see whether daily affect patterns, psychological distress, and awakening cortisol levels were interlinked. Affect levels were assessed using the Day Reconstruction Method and psychological distress was measured using the Depression Anxiety Stress Scales. On average, positive affect increased markedly in a linear pattern across the day, whereas negative affect decreased linearly. For the highly distressed, this pattern was stronger for positive affect. Lower than average morning cortisol, as assessed by two saliva samples at waking and two samples 30 min after waking, predicted a clear increasing pattern of positive affect throughout the day. When we examined the interlinkages between affect patterns, distress, and cortisol, our results showed that a pronounced linear increase in positive affect from morning through to evening occurred chiefly among distressed people with below average cortisol levels upon awakening. Psychological distress, although not strongly associated with morning cortisol levels, does appear to interact with cortisol levels to profoundly influence affect.     

Intergenerational predictors of diurnal cortisol secretion in early childhood

The present study examined potential intergenerational links that may contribute to atypical patterns of diurnal cortisol secretion in early childhood. Salivary cortisol samples were collected across 1 waking day in 36 pre‐school children whose mothers are participants in an ongoing longitudinal project. Hierarchical Linear Modeling (HLM) identified statistically significant predictors of individual differences in daily cortisol trajectories. Children displayed relatively low post‐awakening values and flatter cortisol trajectories across the day as a function of unsupportive maternal behaviour, second‐hand smoke and maternal histories of social withdrawal in childhood. These results suggest that individual differences in young children's pattern of diurnal cortisol are associated with a variety of current and historical maternal characteristics and behaviours. The identification of intergenerational predictors of children's diurnal neuroendocrine functioning may provide new insights into the transfer of health and developmental risk from parent to child. Copyright © 2007 John Wiley & Sons, Ltd.     

Differences between diurnal patterns of salivary cortisol and dehydroepiandrosterone in healthy female adolescents

The adrenal hormones cortisol and dehydroepiandrosterone (DHEA) share a common secretagogue: adrenocorticotropic hormone; however, secretion of these hormones can be dissociated suggesting subtle individual regulation at the level of the adrenal gland. We examined differences in the diurnal patterns of cortisol and DHEA secretion in healthy adolescent girls, with the aim of informing the possibility of exploiting these differences to aid interpretation of data from clinical populations in which these patterns can become dysregulated. Fifty-six healthy females aged 10-18 years provided saliva samples at 0 and 30 min (morning samples) and 12 h post-awakening on 2 consecutive weekdays. For morning salivary cortisol in relation to morning DHEA concentrations, correlational analysis revealed only a trend (p = 0.054). Similarly, the association between evening cortisol and DHEA was characterised as a trend (p = 0.084). Mean morning DHEA concentrations showed more day-to-day consistency than equivalent cortisol samples (r = 0.829 for DHEA and 0.468 for cortisol; z = 3.487, p < 0.0005). Unlike the cortisol pattern, characterised by a marked awakening response (cortisol awakening response, CAR), a significant rise in DHEA concentration post-awakening was not evident. Finally, there was a strong association between morning and evening concentrations of DHEA, not found for cortisol. The study shows differences in cortisol and DHEA secretion in the post-awakening period and informs work that seeks to examine correlates of dysregulated hypothalamic-pituitary-adrenal axis function. Parallel examination of both hormones enables enhanced interpretation of aberrant patterns of the CAR, i.e. an exploration of whether dysregulation affects both hormones (reflecting overall steroidogenic capacity) or cortisol alone (CAR-specific mechanisms).     

Bright light treatment has limited effect in subjects over 55 years with mild early morning awakening

31 subjects, age 55 yr. or older, suffering from mild early morning awakening were randomized to either a bright light (10,000 lux) or to a red dim light placebo condition (200 lux). Light exposure took place in the evening in the patients' homes, 60 to 30 min. before bedtime and lasted for 3 wk. The subjects kept a sleep diary for 2 wk. and wore an actigraph for 1 wk. both before treatment and at post-treatment. Of the eight sleep diary outcome variables, significant effects that could be attributed to the light treatment were only detected for time spent in bed after final morning awakening. None of the six actigraph outcome variables yielded any significant effect of the light therapy. Explanations for the limited therapeutic effects of bright light treatment obtained in the present study are discussed, such as the criteria defining early morning awakening, the selection procedure, problems with compliance, age of the sample, and the dose of light. The lack of an objective circadian marker in this study could represent a problem concerning the timing of the light exposure. Despite the limited success of bright light therapy in this study, bright light therapy should still be considered as a treatment option for early morning awakening.