Effect of pre- and postcompetition emotional state on salivary cortisol in top-ranking wrestlers

The purpose was three-fold: (1) to investigate the effect of baseline, precompetition, and postcompetition stress on salivary cortisol levels in top-ranking Brazilian wrestlers (N = 17) participating in a national competition; (2) to estimate correlations among three stress measures (perceived stress, salivary cortisol, and physiological stress reaction); and (3) to compare cortisol concentrations between losers and winners. Salivary cortisol was collected at baseline, pre-, and postcompetition. Physiological stress reaction and perceived stress scores were measured just before warm-up for the competition. Analysis showed a significant main effect for testing time. Correlations among the stress measures were not significant. Analysis of covariance between the winners (n = 10) and the losers (n = 7) was also not significant. Salivary cortisol concentrations increased after the intense exercise of competition. The wrestlers did not perceive any physiological effects.     

Experimental effects of rumination styles on salivary cortisol responses

Emerging research suggests that rumination increases risk for negative health outcomes. In the first experiment to investigate cortisol responses during angry rumination, participants were provoked and induced to engage in self-focused rumination, provocation-focused rumination, or distraction. Consistent with social threat theory, self-focused rumination maintained high levels of cortisol following provocation, whereas provocation-focused rumination and distraction facilitated decreases in cortisol. However, even within the provocation-focused rumination condition, adopting an emotionally reactive, self-immersed perspective was associated with higher levels of cortisol as were thoughts about the self. Individual differences in displaced aggression but not general aggression were also positively associated with cortisol levels in the provocation-focused condition. The present findings shed light on rumination styles and cortisol responses in ways that may have long-term consequences for health and well-being.

Measurement and meaning of salivary cortisol: a focus on health and disease in children

Measurement of salivary cortisol can provide important information about hypothalamic-pituitary-adrenal (HPA) axis activity under normal conditions and in response to stress. However, there are many variables relating to the measurement of cortisol in saliva which may introduce error and therefore may render difficult the comparison and interpretation of data between, and within, laboratories. This review addresses the effects of gender, age, time and location of sampling, units of measurement, assay conditions and compliance with the protocol, all of which have the potential to impact upon the precision, accuracy and reliability of salivary cortisol measurements in the literature. Some of these factors are applicable to both adults and children, but the measurement of salivary cortisol in children introduces aspects of unique variability which demand special attention. The specific focus of this review is upon the somewhat neglected area of methodological variability of salivary cortisol measurement in children. In addition to these methodological issues, the review highlights the use of salivary cortisol measurements to provide information about HPA axis dysfunction associated with psycho- and patho-physiological conditions in children. Novel applications for salivary cortisol measurements in future research into HPA axis activity in children are also discussed.     

The assessment of cortisol using salivary ultrafiltrate

Cortisol can be used to indicate stress level as well as to monitor certain disease states. Although cortisol can be sampled from blood and urine, saliva sampling has decided advantages. Unfortunately, whole saliva contains a number of substances that can metabolize or bind with cortisol, potentially confounding analysis and quantitation. We introduce a semipermeable pouch that accumulates a contaminant-free salivary ultrafiltrate, thereby overcoming a number of the problems encountered with whole saliva. In three studies, we demonstrate accuracy and utility of the device for cortisol determination: (1) in an artificial medium, 60%–77% of the cortisol was recovered in the ultrafiltrate; (2) in vivo, ultrafiltrate cortisol correlated highly with whole-saliva cortisol collected under ideal conditions; and (3) ultrafiltrate cortisol evinced positive relationships with depression and cigarette use, consistent with studies in the literature. We conclude that this device and saliva-filtering technologies in general are useful in applications requiring quantitation of cortisol.     

The dental anxiety scale and effects of dental fear on salivary cortisol

Only a few studies have investigated use of the Dental Anxiety Scale in dental fear-induced neuroendocrine changes. The present study examined 19 female patients, each at two timepoints across an educational and a treatment session within periodontitis therapy. Subjective measures included a visual analogue scale, the STAI State scale, and the Dental Anxiety Scale. Salivary cortisol was measured in parallel across all four timepoints. Although patients were significantly more aroused and anxious prior to the treatment session, salivary cortisol remained unchanged. However, patients with high Dental Anxiety were significantly more aroused and anxious and showed significantly higher salivary cortisol during the educational session than those with low scores on Dental Anxiety. In conclusion, the Dental Anxiety Scale differentiated mean neuroendocrine change between patients scoring low and high for Dental Anxiety and its use as an accurate tool to identify patients with high dental anxiety should be further studied predictively.     

The effects of SES on infant and maternal diurnal salivary cortisol output

The present study directly compared diurnal salivary cortisol output and maternal-infant synchrony in low and high socio-economic status (SES) mother–infant dyads. Saliva cortisol samples were collected from 32 6–12-month-old infants and their mothers on the same day in the morning, afternoon and evening, and assayed for free cortisol concentration. Low-SES infants and mothers exhibited higher average salivary cortisol output, without dysregulation, compared to high-SES infants. Low-SES infants and mothers also showed reduced synchrony in cortisol output compared to high-SES infants and mothers. Results are discussed with respect to maternal sensitivity and early stress reduction interventions.     

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.     

Relationships between physiological and psychological stress and salivary immunoglobulin A among young female gymnasts

We investigated whether psychological and physical stress induced by training or competition influence the secretory immune system among 12 highly trained young female gymnasts. Salivary levels of secretory IgA and cortisol responses to gymnastic training session or competition were assessed a total of 10 times, immediately before and after two training sessions which had different intensities and just before and after a major competition. These parameters were also measured on two non-training days. The Brunel Mood Scale was also used to assess the gymnasts's overall mood on each test day. IgA:Protein ratio was calculated. Significant decreases in this ratio were found after each exercise session, related to the physiological and psychological stress induced by exercise. Over the 5-mo. training period the presession IgA:Protein ratios were unchanged. Gymnasts registered any episodes of upper respiratory tract infection. Bouts of exercise induce transitory effects on the immune system in relation to the workload and the stress induced by the exercise without any relation to increased susceptibility to illness in children.     

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.     

Psychological correlates of salivary cortisol secretion among unemployed men and women

The aim of the present study was to examine the association between psychological factors and salivary cortisol secretion (baseline level, reactivity to laboratory stressors) in a sample of 59 long-term unemployed men and women (mean age 42±10 years). Subjects were divided into four groups according to their basal levels of salivary cortisol as well as their reactivity to experimental stress (stress level minus baseline): (1) low base/low reactivity; (2) high base/low reactivity; (3) low base/high reactivity; and (4) high base/high reactivity. The low base/low reactivity group was characterized by significantly higher somatic anxiety, muscular tension, irritability, and depression (Beck’s Depression Inventory) and lower perceived control (mastery) than the other groups. The low base/high reactivity group was also characterized by depression and low perceived control. The high base/low reactivity group was higher in terms of monotony avoidance, Type-A behavior (JAS) and mastery, but lower in depression. The results indicate that (1) individuals with personality traits reflecting emotional distress are more vulnerable to exhaustion of the HPA-axis following long-term unemployment and (2) monotony avoidance and Type-A behavior, at least temporarily, seem to exert a beneficial influence on mental well-being among long-term unemployed individuals.     

Relation of intimate partner violence to salivary cortisol among couples expecting a first child

Despite advances in understanding the role that several physiological systems play in the occurrence of general violence, little progress has been made toward understanding biological correlates of intimate partner violence (IPV). We explored involvement of one physiological system, the hypothalamic-pituitary-adrenal (HPA) axis. Among 137 heterosexual couples expecting a first child, baseline level of HPA activity-assessed via salivary cortisol collected before a couple conflict discussion-was linked to both men's and women's violence perpetration. HPA reactivity to the conflict bout did not show an independent association with IPV. However, persisting elevation in men's, and down-regulation in women's, HPA activity during a further recovery period was linked to men's violence perpetration.     

Chronic stress in the mother-infant dyad: Maternal hair cortisol,infant salivary cortisol and interactional synchrony

Stress physiology is shaped by early experience, with enduring effects on health. The relation of chronic maternal physiological stress, as indexed by hair cortisol, to infants’ stress systems and to mother-infant interaction quality has not been established. We examined maternal hair and salivary cortisol, six-month-old infants’ salivary cortisol, and mother-infant interaction in 121 mother-infant dyads. High maternal hair cortisol was related to higher infant average salivary cortisol concentration. Maternal hair cortisol and bedtime salivary cortisol were both uniquely related to infant bedtime salivary cortisol. Mothers with higher hair cortisol were more intrusive and had lower positive engagement synchrony with their infants. Maternal intrusiveness moderated the association of maternal hair cortisol and infant salivary cortisol, such that maternal hair and infant average salivary cortisol were related only when mothers were more intrusive. Maternal chronic physiological stress may upregulate infants’ developing stress systems, particularly in the context of lower mother-infant interaction quality.     

Physiological aspects of flow experiences: Skills-demand-compatibility effects on heart rate variability and salivary cortisol

This research addresses flow theory according to which the compatibility of skills and task demands involved in an activity elicits flow experiences that render the activity intrinsically rewarding. Departing from correlational research, we applied experimental paradigms designed to test the impact of a skills-demands-compatibility on the emergence of flow in computerized tasks. On the one hand, the results from self-reports support the balance hypothesis and indicate that skills-demands-compatibility results in a pleasurable flow experience. On the other hand, the results also indicate that skills-demands-compatibility resulted in (a) reduced heart rate variability indicating enhanced mental workload, and (b) stress as indicated by relatively high levels of salivary cortisol. These results indicate that flow experiences combine subjectively positive elements with physiological elements reflecting strainful tension and mental load.     

Sex differences of salivary cortisol secretion in patients with major depression

Depression is associated with increased cortisol secretion and occurs more often in women than in men. Thus, it has been hypothesized that differences in cortisol secretion might, in part, be responsible for the greater risk of developing depression in women. However, only few studies have examined sex differences in baseline cortisol secretion in depressed patients and healthy controls. We examined sex effects on cortisol secretion in 52 medication-free patients with major depression (37 women, 15 men, mean ± SD age 35 ± 11 years, Hamilton Depression Scale mean score 27 ± 5) and 50 healthy age- and sex-matched control subjects. Salivary cortisol concentrations were measured at 8:00, 12:00, 16:00, and 22:00 h. Repeated measures analysis of covariance revealed a group × sex interaction (p = 0.05). Post hoc tests revealed higher cortisol concentrations in depressed compared to healthy men [F(1;29) = 7.5, p = 0.01]. No differences were found between depressed and non-depressed women. Our results do not support the hypothesis that differences in cortisol secretion between depressed and non-depressed subjects are more pronounced in women than in men. Study characteristics and methods as well as sex-specific confounding variables such as menstrual cycle, menopause and the use of oral contraceptives may account for inconclusive results across studies.     

Intranasal oxytocin and salivary cortisol concentrations during social rejection in university students

Oxytocin facilitates pro-social behaviour and is proposed as a regulatory factor controlling stress reactivity. Previous research on oxytocin and stress has focused on achievement-related stressors among male participants. The aims of the study were to (1) examine the influence of oxytocin on the affective and cortisol response to the Yale Interpersonal Stressor (YIPS), a live social rejection paradigm, and (2) to replicate the finding that women exhibit a greater cortisol response to interpersonal stress than men (Stroud et al. 2002). Sex differences in stress responses: Social rejection versus achievement stress. Biol Psychiat 53:318-327. Ninety-six undergraduate students underwent the YIPS, where participants were excluded from two separate conversations by two same-sex confederates. Salivary cortisol concentrations and mood were repeatedly measured throughout the study. Participants were administered, in a double-blind design, a single dose of intranasal oxytocin (24 IU) or placebo prior to beginning the YIPS. The YIPS elicited a significant negative mood response that was more pronounced in females than in males. However, no significant cortisol response to the stressor and no sex difference in cortisol reactivity were observed. A significant effect of drug condition on cortisol levels was observed. Participants who were administered oxytocin exhibited a decrease in cortisol levels, relative to placebo, during the YIPS, F (4, 184)=4.50, p<0.05. The study failed to replicate the sex difference in the cortisol response to interpersonal stress reported by Stroud et al. (2002). Intranasal oxytocin, however, appeared to reduce cortisol concentrations during an interpersonal challenge.     

Attachment status and salivary cortisol in a normal day and during simulated interpersonal stress in young men

Attachment insecurity, as assessed via the adult attachment interview (AAI), may be expected to relate to basal hypothalamic-pituitary-adrenal (HPA) activity because it is retrodictive of stressful early experiences, which may influence HPA development. In addition, because AAI insecurity may reflect limitations on concurrent cognitive, emotional, and behavioral strategies for managing interpersonal distress, insecurity may also relate to cortisol reactivity specifically during inter-personal challenges. Nevertheless, only two studies have examined associations between AAI insecurity and cortisol, and in total only eight non-clinical men were included. To expand upon past research, the current study focused on college aged men and examined relations between attachment status (via categories and continuous scores) and cortisol levels during daily life and during interpersonal laboratory challenges, wherein subjects were asked to visualize and respond to hypothetical situations concerning loss, separation, and abandonment. Unlike prior research, salivary cortisol was measured during cognitive challenges (e.g. non-autobiographical memory tests), so as to inform questions concerning the specificity of effects. Contrary to expectations, only limited evidence suggested a relation between insecurity and basal HPA functioning. However, in keeping with expectations, associations between insecurity, and in particular dismissing idealization, and comparatively higher cortisol values following interpersonal challenges were observed.     

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).     

Repeated measurement of salivary cortisol within and across days among shy young adults

Temperamental shyness emerges early in childhood and remains relatively stable throughout development and has been associated with high and low levels of the stress hormone cortisol. Studies examining the relation between shyness and cortisol have been limited because they have traditionally collected only one measure of cortisol on a single day in the laboratory, restricting the reliability and diurnal profile of the measure in the participant’s everyday environment. We collected 15 saliva samples across three separate days (i.e., upon waking, +60 min post-waking, +8 h post-waking, +10 h post-waking, and bedtime) in a sample of healthy young adults selected for high and low shyness in order to characterize a portion of the diurnal cortisol rhythm. Overall, shy individuals demonstrated relatively lower cortisol across the day and across multiple mornings than non-shy adults. Higher self-reported social anxiety across multiple measures was also related to lower total cortisol levels across all participants. The present study replicates and extends our previous findings of low salivary cortisol measured in the laboratory in shy adults to repeated measurement in their everyday environments.